MEDICARE: GREGORY CARINCI PSYCHOLOGY INC

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
1	251S00000X	Community/Behavioral Health Agency	PSY22311	CA

General Provider Information

NPI Number	:	1851738934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY CARINCI PSYCHOLOGY INC

Provider Business Mailing Address
First Line	:	3702 RUFFIN RD STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1893
Country	:	US
Telephone Number	:	619-297-4300
Fax Number	:	619-297-4400

Provider Business Practice Location Address
First Line	:	3702 RUFFIN RD STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1893
Country	:	US
Telephone Number	:	619-297-4300
Fax Number	:	619-297-4400

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. GREGORY J CARINCI
Credential	:	PSYD, BCBA-D
Telephone Number	:	619-297-4300

Provider Enumeration Date	:	05/29/2013
Last Update Date	:	11/17/2023

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