Healthcare Provider Details

I. General information

NPI: 1467871772
Provider Name (Legal Business Name): LEGAL MINDS, INC - A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 CALIFORNIA AVE STE 210
BAKERSFIELD CA
93309-1190
US

IV. Provider business mailing address

4520 CALIFORNIA AVE STE 210
BAKERSFIELD CA
93309-1190
US

V. Phone/Fax

Practice location:
  • Phone: 800-792-9129
  • Fax: 855-278-9129
Mailing address:
  • Phone: 800-792-9129
  • Fax: 855-278-9129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY22152
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY22152
License Number StateCA

VIII. Authorized Official

Name: DR. AMYANNE FREEBURG
Title or Position: PRESIDENT
Credential: PSY.D., MSCP
Phone: 800-792-9129