Protected Roots Integrative | |
7817 Herschel Ave Unit 101-102 La Jolla CA 92037-4454 | |
(858) 295-1815 | |
Not Available |
Full Name | Protected Roots Integrative |
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Speciality | Psychologist - Clinical Child & Adolescent |
Location | 7817 Herschel Ave Unit 101-102, La Jolla, California |
Authorized Official Name and Position | Suyeu Kuo (EXECUTIVE CLINICAL DIRECTOR) |
Authorized Official Contact | 9252697451 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Protected Roots Integrative 7817 Herschel Ave Unit 101-102 La Jolla CA 92037-4454 Ph: () - | Protected Roots Integrative 7817 Herschel Ave Unit 101-102 La Jolla CA 92037-4454 Ph: (858) 295-1815 |
NPI Number | 1083318448 |
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Provider Enumeration Date | 03/29/2023 |
Last Update Date | 03/29/2023 |
Certification Date | 03/26/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083318448 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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