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Organization
KRISTIN LULICH ADVANCED PRACTICE REGISTERED NURSING, INC.
Active
Organization
KRISTIN LULICH ADVANCED PRACTICE REGISTERED NURSING, INC.
Active
Other names
Mind Bloom La Jolla
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTIN MARIE LULICH DNP, PMHNP-BC (CEO)
(253) 218-8755
Entity
Organization
Contact information
Practice address
1120 SILVERADO ST, LA JOLLA, CA 92037-4524
(253) 218-8755
Mailing address
1542 MONMOUTH DR, SAN DIEGO, CA 92109-2237
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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