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General NPI Number Information
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NPI Number | 1104720572
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Entity Type | Organization
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Legal Business Name | PATHWAY CLINICAL GROUP, A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 8880 RIO SAN DIEGO DR
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City | SAN DIEGO
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State | CA
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Zip | 92108-1634
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Country | US
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Telephone | 619-485-5678
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Fax | 619-789-1235
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Provider Business Mailing Address
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Address Line | 8880 RIO SAN DIEGO DR
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City | SAN DIEGO
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State | CA
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Zip | 92108-1634
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Country | US
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Telephone | 619-485-5678
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Fax | 619-789-1235
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Authorized Official
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Title or Position | OWNER
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Name | BRANDON ANDREW LOZANO
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Credential |
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Telephone | 619-485-5678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State | NULL
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