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Contact Information

SOUL TIDE PSYCHOTHERAPY PC
3257 CAMINO DE LOS COCHES
CARLSBAD, CA92009-8976
 Phone: 858-945-7421
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Adult Development & Aging

103TA0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Counseling

103TC1900X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

Health

103TH0004X 62 Psychologist, Clinical
 

Psychoanalysis

103TP0814X 62 Psychologist, Clinical
 

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for SOUL TIDE PSYCHOTHERAPY PC

NPI Number 1528856531
LBN Legal business name SOUL TIDE PSYCHOTHERAPY PC
Authorized official TREVOR OLSON - (SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 04/29/2025
Last updated 07/30/2025 - About 10 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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