| Empowered Vida Therapy | |
|
3108 Fifth Ave Ste E San Diego CA 92103-5829 | |
| (858) 707-5148 | |
| Not Available |
| Full Name | Empowered Vida Therapy |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3108 Fifth Ave Ste E, San Diego, California |
| Authorized Official Name and Position | Paola Berg (THERAPIST) |
| Authorized Official Contact | 8587075148 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered Vida Therapy 3108 Fifth Ave Ste E San Diego CA 92103-5829 Ph: (858) 707-5148 | Empowered Vida Therapy 3108 Fifth Ave Ste E San Diego CA 92103-5829 Ph: (858) 707-5148 |
| NPI Number | 1003680711 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003680711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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