Individual
CARA MICHELLE COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3491 KURTZ ST, SAN DIEGO, CA 92110-4430
(619) 320-2404
Mailing address
3491 KURTZ ST STE 150, SAN DIEGO, CA 92110-4430
(619) 320-2404
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
03/27/2025
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