# SOCAL CHILD PSYCHOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235953746
- **Authorized official:** CARRIE JACKSON (PRESIDENT)
- **Authorized official phone:** (803) 206-1550

## Contact information

- **Practice address:** 3252 HOLIDAY CT STE 220, LA JOLLA, CA 92037-1807
- **Practice address phone:** (619) 719-1940
- **Mailing address:** 4661 1/2 OREGON ST, SAN DIEGO, CA 92116-4922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 11/12/2024
- **Last updated:** 07/16/2026