Healthcare Provider Details

I. General information

NPI: 1669933172
Provider Name (Legal Business Name): SILSBY PSYCHOLOGICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 MARINE VIEW AVE STE 300
DEL MAR CA
92014-3926
US

IV. Provider business mailing address

445 MARINE VIEW AVE STE 300
DEL MAR CA
92014-3926
US

V. Phone/Fax

Practice location:
  • Phone: 619-994-3779
  • Fax: 858-724-1963
Mailing address:
  • Phone: 619-994-3779
  • Fax: 858-724-1963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICA C SILSBY
Title or Position: PRESIDENT
Credential: PSYD
Phone: 619-994-3779