Individual
TAI LEXUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3255 WING ST, SAN DIEGO, CA 92110-4638
(619) 241-0608
Mailing address
3255 WING ST, SAN DIEGO, CA 92110-4638
(619) 335-8105
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704014417
VA
101YP2500X
Professional Counselor
Primary
17893
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704014417
RESIDENT IN COUNSELING LISCENSE NUMBER
VA
Enumeration date
07/29/2022
Last updated
03/26/2026
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