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General NPI Number Information
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NPI Number | 1710769716
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Entity Type | Organization
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Legal Business Name | SOULSTICE MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 9891 IRVINE CENTER DR STE 200
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City | IRVINE
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State | CA
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Zip | 92618-4320
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Country | US
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Telephone | 310-853-3128
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Fax |
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Provider Business Mailing Address
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Address Line | 9891 IRVINE CENTER DR STE 200
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City | IRVINE
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State | CA
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Zip | 92618-4320
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Country | US
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Telephone | 310-853-3128
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN YU
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Credential | LMFT
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Telephone | 312-270-1314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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