Therapist Specialist

Specialty details in registry · San Diego, CA

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At a glance

3760 Convoy St Ste 204, San Diego, CA 92111-3744

NPPES record updated May 14, 2013. Public records can lag behind changes at a practice.

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Practice location

3760 Convoy St Ste 204
San Diego, CA 92111-3744
Professional details: NPI, taxonomy & registry record
NPI1033555347
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
314000000X
Enumeration date
May 14, 2013
Record updated
May 14, 2013
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

314000000X · Primary

License reported: 37371 CA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

3760 Convoy St Ste 204
San Diego, CA 92111-3744
Phone
(858) 514-0375
Fax
(858) 514-0383
Mailing address
3760 CONVOY ST STE 204

SAN DIEGO, CA 921113744
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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