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General NPI Number Information
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NPI Number | 1245108364
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Entity Type | Organization
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Legal Business Name | PELICAN COVE COUNSELING CENTERS
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 240 S GARFIELD AVE STE 201
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City | ALHAMBRA
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State | CA
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Zip | 91801-6812
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Country | US
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Telephone | 626-214-8590
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Fax |
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Provider Business Mailing Address
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Address Line | 240 S GARFIELD AVE STE 201
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City | ALHAMBRA
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State | CA
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Zip | 91801-6812
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Country | US
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Telephone | 626-214-8590
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN, BOARD OF DIRECTORS
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Name | SONI GIBBONS
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Credential | PSY.D.
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Telephone | 310-486-5854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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