Organization
NEUROEVOLVE INTEGRATIVE HEALTH, A PROFESSIONAL PSYCHOLOGY CORPORATION
Active
Organization
NEUROEVOLVE INTEGRATIVE HEALTH, A PROFESSIONAL PSYCHOLOGY CORPORATION
Active
Other names
NeuroEvolve Integrative Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA D WILSON PSYD, LCSW (CFO)
(760) 616-9311
Entity
Organization
Contact information
Practice address
10085 CARROLL CANYON RD STE 200H, SAN DIEGO, CA 92131-1100
(858) 208-3463
Mailing address
10085 CARROLL CANYON RD STE 200H, SAN DIEGO, CA 92131-1100
(858) 208-3463
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/12/2024
Last updated
11/06/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up