Provider Demographics
NPI:1699065961
Name:FELAN, MARCIAL (LMFT)
Entity type:Individual
Prefix:DR
First Name:MARCIAL
Middle Name:
Last Name:FELAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 CERCA BLANCA PL
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-2028
Mailing Address - Country:US
Mailing Address - Phone:619-212-5222
Mailing Address - Fax:
Practice Address - Street 1:7777 AVARADO RD.
Practice Address - Street 2:SUITE #255
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-212-5222
Practice Address - Fax:619-328-6856
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist