Healthcare Provider Details

I. General information

NPI: 1013616564
Provider Name (Legal Business Name): IN DUE TIME PSYCHOLOGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6755 MIRA MESA BLVD STE 123-295
SAN DIEGO CA
92121-4392
US

IV. Provider business mailing address

6755 MIRA MESA BLVD STE 123-295
SAN DIEGO CA
92121-4392
US

V. Phone/Fax

Practice location:
  • Phone: 619-800-8232
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. APRIL JOHNSON
Title or Position: CEO
Credential: PSYD
Phone: 619-800-8232