| Sandy Foot Spc | |
|
615 Prospect St La Jolla CA 92037-4226 | |
| (706) 459-1235 | |
| Not Available |
| Full Name | Sandy Foot Spc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 615 Prospect St, La Jolla, California |
| Authorized Official Name and Position | Juliette Benitez (PRESIDENT) |
| Authorized Official Contact | 7064591235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandy Foot Spc 9525 Genesee Ave Apt 211 San Diego CA 92121-2024 Ph: (706) 459-1235 | Sandy Foot Spc 615 Prospect St La Jolla CA 92037-4226 Ph: (706) 459-1235 |
| NPI Number | 1891529749 |
|---|---|
| Provider Enumeration Date | 08/30/2024 |
| Last Update Date | 08/30/2024 |
| Certification Date | 08/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891529749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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