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General NPI Number Information
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NPI Number | 1508719758
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Entity Type | Organization
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Legal Business Name | ITERRA PSYCHOLOGICAL SERVICES, APC
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 12636 HIGH BLUFF DR STE 400
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City | SAN DIEGO
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State | CA
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Zip | 92130-2071
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Country | US
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Telephone | 619-830-9552
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 740244
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City | SAN DIEGO
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State | CA
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Zip | 92174-0244
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Country | US
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Telephone | 619-830-9552
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILIP WATSON
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Credential | PSYD
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Telephone | 619-830-9552
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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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