Healthcare Provider Details

I. General information

NPI: 1083581045
Provider Name (Legal Business Name): LE TRAJET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7951 OTHELLO AVE
SAN DIEGO CA
92111-3759
US

IV. Provider business mailing address

7951 OTHELLO AVE STE 101
SAN DIEGO CA
92111-3759
US

V. Phone/Fax

Practice location:
  • Phone: 619-797-5917
  • Fax:
Mailing address:
  • Phone: 619-797-5917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSETTE CANNON
Title or Position: CLINICAL DIRECTOR/OWNER
Credential: LMFT
Phone: 619-723-5015