Healthcare Provider Details

I. General information

NPI: 1871009332
Provider Name (Legal Business Name): FARROW PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 12/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 CARMEL MOUNTAIN RD STE F
SAN DIEGO CA
92129-2160
US

IV. Provider business mailing address

9330 CARMEL MOUNTAIN RD STE F
SAN DIEGO CA
92129-2160
US

V. Phone/Fax

Practice location:
  • Phone: 858-480-1484
  • Fax: 858-780-9953
Mailing address:
  • Phone: 858-480-1484
  • Fax: 858-780-9953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES FARROW
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 858-480-1484