Healthcare Provider Details

I. General information

NPI: 1427993484
Provider Name (Legal Business Name): PSYCHOLOGY AND WELLNESS INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 216
SAN DIEGO CA
92130-2054
US

IV. Provider business mailing address

701 GARDEN VIEW CT
ENCINITAS CA
92024-2464
US

V. Phone/Fax

Practice location:
  • Phone: 858-699-2447
  • Fax:
Mailing address:
  • Phone: 858-699-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH ROCHE
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 858-699-2447