Healthcare Provider Details

I. General information

NPI: 1821918327
Provider Name (Legal Business Name): SOUL SHINING PSYCHOLOGY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5938 PRIESTLY DR STE 103
CARLSBAD CA
92008-8847
US

IV. Provider business mailing address

3243 CRECIDA WAY
CARLSBAD CA
92010-5663
US

V. Phone/Fax

Practice location:
  • Phone: 442-264-7148
  • Fax:
Mailing address:
  • Phone: 303-909-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: ARIANNA ZABRISKIE
Title or Position: CEO
Credential: PSYD
Phone: 303-909-9935