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General NPI Number Information
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NPI Number | 1043616121
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Entity Type | Organization
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Legal Business Name | GENUINE PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 04/12/2015
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Provider Practice Location Address
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Address Line | 3636 4TH AVE SUITE 304
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City | SAN DIEGO
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State | CA
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Zip | 92103-4280
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Country | US
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Telephone | 858-386-0993
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Fax | 858-408-7416
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Provider Business Mailing Address
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Address Line | 3636 4TH AVE SUITE 304
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City | SAN DIEGO
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State | CA
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Zip | 92103-4280
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Country | US
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Telephone | 858-386-0993
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Fax | 858-408-7416
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Authorized Official
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Title or Position | OWNER
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Name | DR. RACHEL L VIERS
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Credential | PSY.D.
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Telephone | 858-386-0993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25309
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License Number State | CA
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