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Organization

IVY GLENN WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN BACHMAN PHD (OWNER)
(858) 663-0651
Entity
Organization

Contact information

Practice address
30011 IVY GLENN DR STE 216, LAGUNA NIGUEL, CA 92677-5018
(949) 484-9161
Mailing address
30011 IVY GLENN DR STE 216, LAGUNA NIGUEL, CA 92677-5018
(949) 484-9161

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
12/16/2018
Last updated
12/16/2018
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