Provider Demographics
NPI:1982254397
Name:PRACTICE OF BEING HUMAN PSYCHOLOGY PC
Entity Type:Organization
Organization Name:PRACTICE OF BEING HUMAN PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-945-7421
Mailing Address - Street 1:835 5TH AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6136
Mailing Address - Country:US
Mailing Address - Phone:858-945-7421
Mailing Address - Fax:833-536-2427
Practice Address - Street 1:835 5TH AVE STE 307
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-6136
Practice Address - Country:US
Practice Address - Phone:858-945-7421
Practice Address - Fax:833-536-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty