Organization
OPAL PSYCHOLOGICAL PROFESSIONAL CORPORATION
Active
Organization
OPAL PSYCHOLOGICAL PROFESSIONAL CORPORATION
Active
Other names
Opal Psychological
Organization subpart
No
Provider details
NPI number
Authorized official
LADERA NICOLE PEREZ LINN PSYD (PRESIDENT)
(619) 259-0107
Entity
Organization
Contact information
Practice address
4210 BROOKE CT UNIT 1405, SAN DIEGO, CA 92122-5362
(619) 259-0107
Mailing address
1111 6TH AVE STE 550, #292745, SAN DIEGO, CA 92101
(619) 259-0107
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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