Healthcare Provider Details

I. General information

NPI: 1962184713
Provider Name (Legal Business Name): THROUGH THE MIND PSYCHOLOGICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD STE 5043
LONG BEACH CA
90807-3315
US

IV. Provider business mailing address

3711 LONG BEACH BLVD STE 5043
LONG BEACH CA
90807-3315
US

V. Phone/Fax

Practice location:
  • Phone: 310-367-2630
  • Fax:
Mailing address:
  • Phone: 310-367-2630
  • 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 Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA SIKKELAND
Title or Position: CEO
Credential:
Phone: 310-367-2630