Healthcare Provider Details

I. General information

NPI: 1154954303
Provider Name (Legal Business Name): PSYCHOLOGICAL BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 PALMA DR FL 2
VENTURA CA
93003-6451
US

IV. Provider business mailing address

1500 PALMA DR FL 2
VENTURA CA
93003-6451
US

V. Phone/Fax

Practice location:
  • Phone: 805-626-0325
  • Fax: 888-958-5269
Mailing address:
  • Phone: 805-626-0325
  • Fax: 888-958-5269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALFREDO BIMBELA
Title or Position: OWNER/CEO
Credential: PHD, PMHNP, FNP
Phone: 805-284-1783