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1539 Garnett Ave. San Diego CA 92109 | |
| (619) 762-4632 | |
| (866) 675-5593 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 1539 Garnett Ave., San Diego, California |
| Authorized Official Name and Position | Derik Brian (OWNER) |
| Authorized Official Contact | 9493700771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
400 Alton Road Th-4a Miami Beach FL 33139 Ph: (949) 370-0771 | 1539 Garnett Ave. San Diego CA 92109 Ph: (619) 762-4632 |
| NPI Number | 1982996724 |
|---|---|
| Provider Enumeration Date | 05/12/2011 |
| Last Update Date | 03/01/2024 |
| Certification Date | 03/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982996724 | NPI | - | NPPES |
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