Provider Demographics
NPI:1538425442
Name:MIDGLEY, CARA ANNE ILIFF (MFT)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:ANNE ILIFF
Last Name:MIDGLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17140 BERNARDO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2093
Mailing Address - Country:US
Mailing Address - Phone:858-451-5190
Mailing Address - Fax:
Practice Address - Street 1:17140 BERNARDO CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2093
Practice Address - Country:US
Practice Address - Phone:858-451-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist