Healthcare Provider Details

I. General information

NPI: 1487518262
Provider Name (Legal Business Name): TRANSFORMATIVE ACCEPTANCE PSYCHOLOGICAL SERVICES, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 BALBOA BLVD STE 212
ENCINO CA
91316
US

IV. Provider business mailing address

1111 6TH AVE STE 550
SAN DIEGO CA
92101-5211
US

V. Phone/Fax

Practice location:
  • Phone: 562-256-5862
  • Fax:
Mailing address:
  • Phone: 562-256-5862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: WESCINA LOWE
Title or Position: CEO
Credential: PSYCHOLOGIST
Phone: 562-256-5862