Healthcare Provider Details

I. General information

NPI: 1780397414
Provider Name (Legal Business Name): ALPHA PSYCHOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11440 W BERNARDO CT STE 300
SAN DIEGO CA
92127-1644
US

IV. Provider business mailing address

11440 W BERNARDO CT STE 300
SAN DIEGO CA
92127-1644
US

V. Phone/Fax

Practice location:
  • Phone: 858-790-8810
  • Fax: 855-965-4080
Mailing address:
  • Phone: 858-790-8810
  • Fax: 855-965-4080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. APRIL MINJAREZ
Title or Position: CLINICAL PSYCHOLOGIST, CEO
Credential: PHD, LMFT
Phone: 858-790-8810