Green Lotus Psychotherapy & Consulting, INC.
Psychologist, Clinical in San Diego, CA. Organization (NPI-2).
NPI number1427477751
StatusActive
Last updated in NPPESFeb 7, 2024
Details
- NPI
- 1427477751
- Entity type
- Organization (NPI-2)
- Legal business name
- Green Lotus Psychotherapy & Consulting, INC.
- Organization subpart
- No
- Enumeration date
- Apr 15, 2014
- Certification date
- Feb 2, 2024
- Last updated
- Feb 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PSY20351 | CA | Yes |
Practice location
10455 Pomerado RdSan Diego, CA 92131
Phone 858-344-2668 · Fax 760-262-3026
Mailing address
Po Box 2253Rancho Mirage, CA 92270-1085
Phone 858-344-2668 · Fax 760-262-3026
Authorized official
Jody Bantz
President/Clinical Psychologist
8583442668
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