Healthcare Provider Details
I. General information
NPI: 1760215263
Provider Name (Legal Business Name): WILLIAM CURCI PSYCHOLOGY, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8950 VILLA LA JOLLA DR STE B223
LA JOLLA CA
92037-1715
US
IV. Provider business mailing address
8950 VILLA LA JOLLA DR STE B223
LA JOLLA CA
92037-1715
US
V. Phone/Fax
- Phone: 760-213-9377
- Fax:
- Phone: 760-213-9377
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0700X |
| Taxonomy | Adult Development & Aging Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
CURCI
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 760-213-9377