Organization
MINDBODYOLOGY FAMILY THERAPY INC
Active
Organization
MINDBODYOLOGY FAMILY THERAPY INC
Active
Other names
MINDBODYOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
SHALISS PADILLA LMFT (OWNER)
(833) 444-6463
Entity
Organization
Contact information
Practice address
440 S MELROSE DR STE 200, VISTA, CA 92081-6666
(833) 444-6463
Mailing address
440 S MELROSE DR STE 202, VISTA, CA 92081-6666
(833) 444-6463
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2019
Last updated
03/24/2022
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