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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