| Restore Psychology A Professional Corporation | |
|
1110 24th Street Apt 8 San Diego CA 92102-2000 | |
| (337) 517-7130 | |
| Not Available |
| Full Name | Restore Psychology A Professional Corporation |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 1110 24th Street, San Diego, California |
| Authorized Official Name and Position | Jacob Ambrose (PRESIDENT) |
| Authorized Official Contact | 3375177130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Psychology A Professional Corporation 1110 24th Street Apt 8 San Diego CA 92102-2000 Ph: (337) 517-7130 | Restore Psychology A Professional Corporation 1110 24th Street Apt 8 San Diego CA 92102-2000 Ph: (337) 517-7130 |
| NPI Number | 1154176295 |
|---|---|
| Provider Enumeration Date | 04/22/2024 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154176295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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