| Live Well Therapy | |
|
2535 Camino Del Rio S Ste 145 San Diego CA 92108-3762 | |
| (619) 333-5159 | |
| Not Available |
| Full Name | Live Well Therapy |
|---|---|
| Speciality | Psychologist |
| Location | 2535 Camino Del Rio S Ste 145, San Diego, California |
| Authorized Official Name and Position | Jessica Hughes (OWNER) |
| Authorized Official Contact | 6193305159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Well Therapy 2535 Camino Del Rio S Ste 145 San Diego CA 92108-3762 Ph: () - | Live Well Therapy 2535 Camino Del Rio S Ste 145 San Diego CA 92108-3762 Ph: (619) 333-5159 |
| NPI Number | 1346830429 |
|---|---|
| Provider Enumeration Date | 01/22/2021 |
| Last Update Date | 06/24/2022 |
| Certification Date | 06/24/2022 |
| Medicare PECOS PAC ID | 6608284583 |
|---|---|
| Medicare Enrollment ID | O20210413002374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346830429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Jessica Andrea Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215346887 PECOS PAC ID: 3577808849 Enrollment ID: I20181214002965 |
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