Healthcare Provider Details

I. General information

NPI: 1912184219
Provider Name (Legal Business Name): MEMORY CHECK PSYCHOLOGICAL SERVICES, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 WRIGHT PL FL CENTER2
CARLSBAD CA
92008-6583
US

IV. Provider business mailing address

PO BOX 68050
NEWARK NJ
07101-8086
US

V. Phone/Fax

Practice location:
  • Phone: 888-515-3834
  • Fax:
Mailing address:
  • Phone: 888-515-3834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. VIKAS DUVVURI
Title or Position: OWNER
Credential: MD
Phone: 888-515-3834