Healthcare Provider Details

I. General information

NPI: 1326805979
Provider Name (Legal Business Name): SOUTHERN CALIFORNIA PSYCHOLOGY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27433 TOURNEY RD STE 160
VALENCIA CA
91355-5613
US

IV. Provider business mailing address

25112 SOUTHWIND CT
STEVENSON RANCH CA
91381-2265
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-2722
  • Fax:
Mailing address:
  • Phone: 661-259-2722
  • Fax:

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. JEFFREY MORROW
Title or Position: PRESIDENT/CEO
Credential: PHD
Phone: 661-259-2722