Organization
KULA WELLNESS PSYCHOLOGICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA TAVERNITI PSY.D. BCBA-D (OWNER/CLINICIAN)
(937) 631-4059
Entity
Organization
Contact information
Practice address
6455 LA JOLLA BLVD UNIT 142, LA JOLLA, CA 92037-6633
(619) 800-8145
Mailing address
6455 LA JOLLA BLVD UNIT 142, LA JOLLA, CA 92037-6633
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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