RESILIENT ROOTS THERAPY PC NPI 1598696577

NPI Information

  • NPI: 1598696577
  • Provider Name: RESILIENT ROOTS THERAPY PC
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 6555 AMBROSIA DR
    SAN DIEGO, CA
    ZIP 92124
  • Phone: (213) 537-2874

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NPI Details

RESILIENT ROOTS THERAPY PC is an adult mental health clinic center in San Diego, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. RESILIENT ROOTS THERAPY PC NPI is 1598696577. The provider is registered as an organization entity type.

The provider's business location address is:

6555 AMBROSIA DR
SAN DIEGO, CA
ZIP 92124-226
Phone: (213) 537-2874

The provider's authorized official is Ashanti Miranda .
The authorized official title is Owner/operator and has the following contact phone number (213) 537-2874.

The enumeration date for this NPI number is 5/27/2026 and was last updated on 5/27/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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