Healthcare Provider Details

I. General information

NPI: 1790696656
Provider Name (Legal Business Name): ONE PLACE HOLISTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11665 AVENA PL STE 205
SAN DIEGO CA
92128-2428
US

IV. Provider business mailing address

11665 AVENA PL STE 205
SAN DIEGO CA
92128-2428
US

V. Phone/Fax

Practice location:
  • Phone: 858-733-0832
  • Fax: 844-517-0703
Mailing address:
  • Phone: 858-733-0832
  • Fax: 844-517-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: TERESA SIMONSON
Title or Position: CEO
Credential: L.AC
Phone: 858-733-0832