Provider Demographics
NPI:1376134247
Name:ALOHA SPIRIT THERAPY
Entity Type:Organization
Organization Name:ALOHA SPIRIT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT 114473
Authorized Official - Phone:858-209-4955
Mailing Address - Street 1:2706 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-3116
Mailing Address - Country:US
Mailing Address - Phone:858-209-4955
Mailing Address - Fax:
Practice Address - Street 1:731 S HIGHWAY 101 STE 1E
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2628
Practice Address - Country:US
Practice Address - Phone:858-209-4955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)