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General NPI Number Information
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NPI Number | 1710797717
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Entity Type | Organization
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Legal Business Name | BALBOA THERAPY GROUP, INC.
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 2150 COMSTOCK ST # 710101
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City | SAN DIEGO
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State | CA
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Zip | 92111-6689
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Country | US
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Telephone | 619-762-6277
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Fax | 619-415-8171
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Provider Business Mailing Address
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Address Line | 2150 COMSTOCK ST # 710101
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City | SAN DIEGO
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State | CA
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Zip | 92111-6689
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SARAH HOUCK
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Credential | LPCC
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Telephone | 619-848-6007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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