| Protected Roots Integrative | |
|
7817 Herschel Ave Unit 101-102 La Jolla CA 92037-4454 | |
| (858) 295-1815 | |
| Not Available |
| Full Name | Protected Roots Integrative |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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