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General NPI Number Information
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NPI Number | 1679360085
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Entity Type | Organization
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Legal Business Name | WELLSPHERE PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 5252 BALBOA AVE STE 602
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City | SAN DIEGO
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State | CA
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Zip | 92117-6932
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Country | US
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Telephone | 858-342-0354
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Fax |
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Provider Business Mailing Address
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Address Line | 5252 BALBOA AVE STE 602
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City | SAN DIEGO
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State | CA
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Zip | 92117-6932
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Country | US
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Telephone | 858-342-0354
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARISA ZENS
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Credential | PSYD
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Telephone | 858-342-0354
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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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