Provider Demographics
NPI:1851949937
Name:ENERGY PSYCHOLOGY & WELLNESS INC
Entity Type:Organization
Organization Name:ENERGY PSYCHOLOGY & WELLNESS INC
Other - Org Name:ENERGY PSYCHOLOGY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMTHU
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-717-4196
Mailing Address - Street 1:4565 RUFFNER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2258
Mailing Address - Country:US
Mailing Address - Phone:858-717-4196
Mailing Address - Fax:
Practice Address - Street 1:4565 RUFFNER ST STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2258
Practice Address - Country:US
Practice Address - Phone:858-717-4196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-31
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)