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General NPI Number Information
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NPI Number | 1386159374
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Entity Type | Organization
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Legal Business Name | LEARNING TO BE HUMAN
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 835 5TH AVE STE 407
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City | SAN DIEGO
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State | CA
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Zip | 92101-6137
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Country | US
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Telephone | 858-255-1658
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Fax | 619-546-0642
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Provider Business Mailing Address
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Address Line | 2525 A ST
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City | SAN DIEGO
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State | CA
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Zip | 92102-2109
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Country | US
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Telephone | 858-945-7421
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Fax | 619-546-0642
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. TREVOR JAMES OLSON
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Credential | PSY.D.
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Telephone | 858-255-1658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PSY28474
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License Number State | CA
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