SOUL TIDE PSYCHOTHERAPY PC
NPI 1528856531
Psychologist - Clinical in Carlsbad, CA

Q: What is Soul Tide Psychotherapy PC's NPI number?

The NPI number for Soul Tide Psychotherapy PC is 1528856531. It was assigned to this organization in the NPPES registry on April 29, 2025.

Q: What is Soul Tide Psychotherapy PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since April 29, 2025

3257 CAMINO DE LOS COCHES, CARLSBAD, CA 92009(858) 945-7421 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Soul Tide Psychotherapy Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUL TIDE PSYCHOTHERAPY PC (NPI 1528856531) is a healthcare organization registered as a clinical in Carlsbad, California and active in the NPI registry since April 2025. The organization lists Trevor Olson, Secretary, as its authorized official.

NPPES Registry Identity

NPI1528856531

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameSOUL TIDE PSYCHOTHERAPY PC

Location Address3257 CAMINO DE LOS COCHESCarlsbad, CA 92009-8976

Mailing Address2204 Irving AveSan Diego, CA 92113-2301 · (858) 945-7421

Phone(858) 945-7421

Organization SubpartNo

Authorized OfficialTrevor OlsonSecretary · (858) 945-7421

Enumeration DateApril 29, 2025

Last NPPES UpdateJuly 30, 2025

NPPES CertifiedJuly 30, 2025

✔ NPI 1528856531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 10

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

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.

Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X

Also ListedPsychologist · Adult Development & AgingTaxonomy 103TA0700X

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X

Also ListedPsychologist · CounselingTaxonomy 103TC1900X

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X

Also ListedPsychologist · FamilyTaxonomy 103TF0000X

Also ListedPsychologist · HealthTaxonomy 103TH0004X

Also ListedPsychologist · PsychoanalysisTaxonomy 103TP0814X

Also ListedPsychologist · RehabilitationTaxonomy 103TR0400X

3257 CAMINO DE LOS COCHES, Carlsbad, CA 92009

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Soul Tide Psychotherapy Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Soul Tide Psychotherapy PC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Kyle Cablay

Marriage and Family Therapist

NPI 1093254187

340 RANCHEROS DR STE 166
San Marcos, CA 92069

(760) 744-3672

✔ PECOS6.5 mi

Trevor Olson, PSY.D.

Clinical Psychologist

NPI 1972956373

8813 VILLA LA JOLLA DR STE 2002
La Jolla, CA 92037

(858) 255-1658

✔ PECOS✔ Accepts Medicare14 mi

Blanca Iniguez Valdivia, LCSW

Clinical Social Worker

NPI 1447759683

2515 CAMINO DEL RIO S STE 240
San Diego, CA 92108

(619) 549-0329

✔ PECOS22 mi

Jessica Anderson

Clinical Social Worker

NPI 1710639869

964 5TH AVE
San Diego, CA 92101

(858) 255-1658

✔ PECOS✔ Accepts Medicare25 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soul Tide Psychotherapy PC's NPI number?

The NPI number for Soul Tide Psychotherapy PC is 1528856531. It was assigned to this organization in the NPPES registry on April 29, 2025.

Where is Soul Tide Psychotherapy PC located?

Soul Tide Psychotherapy PC is located at 3257 Camino De Los Coches, Carlsbad, CA 92009. The listed phone number is (858) 945-7421.

What is Soul Tide Psychotherapy PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Soul Tide Psychotherapy PC enrolled in Medicare?

Yes. Soul Tide Psychotherapy PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Soul Tide Psychotherapy PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Soul Tide Psychotherapy PC, in Clinical Psychologist, Clinical Social Worker and Marriage and Family Therapist. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Soul Tide Psychotherapy PC was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.