Healthcare Provider Details

I. General information

NPI: 1730711375
Provider Name (Legal Business Name): BENJAMIN ALPERT, PSYD, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CAMINO DEL RIO S STE 305 OFFICE2
SAN DIEGO CA
92108-3717
US

IV. Provider business mailing address

2525 CAMINO DEL RIO S STE 305 OFFICE 2
SAN DIEGO CA
92108-3717
US

V. Phone/Fax

Practice location:
  • Phone: 845-570-1278
  • Fax:
Mailing address:
  • Phone: 845-570-1278
  • 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 Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN ALPERT
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 587-514-3688