Provider Demographics
NPI:1235593757
Name:ARILDA SURRIDGE, LMFT
Entity Type:Organization
Organization Name:ARILDA SURRIDGE, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARILDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SURRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-997-3260
Mailing Address - Street 1:6994 EL CAMINO REAL STE 205
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4118
Mailing Address - Country:US
Mailing Address - Phone:619-997-3260
Mailing Address - Fax:
Practice Address - Street 1:6994 EL CAMINO REAL STE 205
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4118
Practice Address - Country:US
Practice Address - Phone:619-997-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84629106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty