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NPI Code Detail

MEDICARE: TONI GALACE PSYD

MEDICARE: TONI GALACE PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY28429CA

General Provider Information

NPI Number : 1376085027
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI GALACE PSYD
Provider Business Mailing Address
First Line : 830 SCENIC TERRACE PL
Second Line :
City : CHULA VISTA
State : CA
Zip : 91914-2621
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 750 B ST STE 2870
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-8132
Country : US
Telephone Number : 619-722-0014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2016
Last Update Date : 11/12/2016

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