Healthcare Provider Details
I. General information
NPI: 1235810722
Provider Name (Legal Business Name): SOULTENDERS PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2023
Last Update Date: 09/11/2025
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41 E FOOTHILL BLVD STE 102
ARCADIA CA
91006-2361
US
IV. Provider business mailing address
41 E FOOTHILL BLVD STE 102
ARCADIA CA
91006-2361
US
V. Phone/Fax
- Phone: 626-701-4249
- Fax: 626-737-6034
- Phone: 626-701-4249
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WENDY
L
SELEVITCH
Title or Position: OWNER
Credential: PHD
Phone: 626-701-4249