SOUL TIDE PSYCHOTHERAPY
NPI 1528856531
Psychologist - Clinical in San Diego, CA

NPI Status: Active since April 29, 2025

Contact Information

742 SANTA RITA PL
SAN DIEGO, CA
ZIP 92109
Phone: (858) 945-7421

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  • Organization
  • Psychologist
  • Clinical

About SOUL TIDE PSYCHOTHERAPY

This page provides the complete NPI Profile along with additional information for Soul Tide Psychotherapy, a provider established in San Diego, California operating as a Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1528856531 assigned on April 2025. The practitioner's primary taxonomy code is 103TC0700X. The provider is registered as an organization and their NPI record was last updated April 2025. Soul Tide Psychotherapy operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Trevor Olson Psy.d. (Secretary)

NPI
1528856531
Provider Name
SOUL TIDE PSYCHOTHERAPY
Entity Type
Organization
Location Address
742 SANTA RITA PL SAN DIEGO, CA 92109
Location Phone
(858) 945-7421
Mailing Address
742 SANTA RITA PL SAN DIEGO, CA 92109
Mailing Phone
(858) 945-7421
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-29-2025
Last Update Date
04-29-2025
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A clinical psychologist like Soul Tide Psychotherapy assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist Clinical

Taxonomy Code
103TC0700X
Type
Behavioral Health & Social Service Providers
Taxonomy Description
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1103TA0400XBehavioral Health & Social Service Providers

Psychologist
Addiction (Substance Use Disorder)

 
2103TA0700XBehavioral Health & Social Service Providers

Psychologist
Adult Development & Aging

 
3103TB0200XBehavioral Health & Social Service Providers

Psychologist
Cognitive & Behavioral

 
4103TC1900XBehavioral Health & Social Service Providers

Psychologist
Counseling

 
5103TC2200XBehavioral Health & Social Service Providers

Psychologist
Clinical Child & Adolescent

 
6103TF0000XBehavioral Health & Social Service Providers

Psychologist
Family

 
7103TH0004XBehavioral Health & Social Service Providers

Psychologist
Health

 
8103TP0814XBehavioral Health & Social Service Providers

Psychologist
Psychoanalysis

 
9103TR0400XBehavioral Health & Social Service Providers

Psychologist
Rehabilitation

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TREVOR OLSON PSY.D.

Authorized Official Title
SECRETARY
Authorized Official Phone
(858) 945-7421

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1528856531
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25481651256
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 4 + 8 + 1 + 6 + 5 + 1 + 2 + 5 + 6 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1528856531 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528856531, enumerated in the NPI registry as an "organization" on April 29, 2025

The provider is located at 742 Santa Rita Pl San Diego, Ca 92109 and the phone number is (858) 945-7421

This medical organization specializes in Psychologist with taxonomy code 103TC0700X with a focus in Clinical

This NPI record was last updated on April 29, 2025. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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