Organization
RED COUCH CHILD AND INDIVIDUAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACIE WILCOCK LMFT (OWNER/CLINICIAN)
(208) 869-2393
Entity
Organization
Contact information
Practice address
10620 TREENA ST STE 230, SAN DIEGO, CA 92131-1140
(858) 252-5150
(858) 999-2537
Mailing address
10620 TREENA ST STE 230, SAN DIEGO, CA 92131-1140
(858) 252-5150
(858) 999-2537
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992047369
NPPES
CA
Enumeration date
03/20/2026
Last updated
03/25/2026
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