Healthcare Provider Details

I. General information

NPI: 1740126200
Provider Name (Legal Business Name): ABSOLUTE THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 RUFFNER ST STE S
SAN DIEGO CA
92111-2249
US

IV. Provider business mailing address

4645 RUFFNER ST STE S
SAN DIEGO CA
92111-2249
US

V. Phone/Fax

Practice location:
  • Phone: 619-489-3197
  • Fax: 619-489-3197
Mailing address:
  • Phone: 619-802-3038
  • Fax: 619-489-3197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. LUCAS ROCHA LACERDA
Title or Position: PRESIDENT
Credential: MA
Phone: 619-489-3197