Organization
ALPHA THETA CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VILLANUEVA PHD (CEO/CLINIC DIRECTOR)
(858) 952-7660
Entity
Organization
Contact information
Practice address
6540 LUSK BLVD STE C175, SAN DIEGO, CA 92121-2768
(858) 952-7660
Mailing address
6540 LUSK BLVD STE C175, SAN DIEGO, CA 92121-2768
(858) 952-7660
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
01/27/2021
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