Healthcare Provider Details

I. General information

NPI: 1215596846
Provider Name (Legal Business Name): WITHIN SIGHT PSYCHOLOGICAL AND INTEGRATED SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 BALBOA AVE
SAN DIEGO CA
92117-6906
US

IV. Provider business mailing address

3960 W POINT LOMA BLVD. STE H #56720 STE H #56720
SAN DIEGO CA
92110
US

V. Phone/Fax

Practice location:
  • Phone: 858-366-7973
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CANDACE FANALE
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 818-442-3882