Healthcare Provider Details

I. General information

NPI: 1750384350
Provider Name (Legal Business Name): AFFILIATED PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6274 ADOBE RD
TWENTYNINE PALMS CA
92277-2650
US

IV. Provider business mailing address

6274 ADOBE RD
TWENTYNINE PALMS CA
92277-2650
US

V. Phone/Fax

Practice location:
  • Phone: 760-369-7166
  • Fax: 760-369-7167
Mailing address:
  • Phone: 760-369-7166
  • Fax: 760-369-7167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JAN COVEY
Title or Position: GENERAL PARTNER
Credential:
Phone: 760-369-7166