| Sea Glass Psychological Services, Inc. | |
|
380 S Melrose Dr Ste 364 Vista CA 92081-6641 | |
| (760) 477-3359 | |
| (760) 494-0575 |
| Full Name | Sea Glass Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 380 S Melrose Dr Ste 364, Vista, California |
| Authorized Official Name and Position | Cristina Elena Bustos (LICENSED PSYCHOLOGIST & CEO) |
| Authorized Official Contact | 7604773359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Glass Psychological Services, Inc. 380 S Melrose Dr Ste 364 Vista CA 92081-6641 Ph: (760) 477-3359 | Sea Glass Psychological Services, Inc. 380 S Melrose Dr Ste 364 Vista CA 92081-6641 Ph: (760) 477-3359 |
| NPI Number | 1275125700 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 02/05/2021 |
| Certification Date | 02/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275125700 | NPI | - | NPPES |
| 1255771135 | Other | PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Vista Wiac Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 W Vista Way Ste 109, Vista, CA 92083 Phone: 310-945-3350 Fax: 310-840-7023 | |
Mindbodyology Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 S Melrose Dr Ste 200, Vista, CA 92081 Phone: 833-444-6463 | |
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