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General NPI Number Information
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NPI Number | 1114454238
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Entity Type | Organization
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Legal Business Name | ONE DOOR PSYCHOLOGY, INC
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Dates
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Enumeration Date | 05/19/2017
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 680 LIGHTHOUSE AVE UNIT 51355
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-8071
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Country | US
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Telephone | 831-402-3838
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Fax | 831-747-1095
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Provider Business Mailing Address
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Address Line | 680 LIGHTHOUSE AVE UNIT 51355
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-8071
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Country | US
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Telephone | 831-402-3838
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Fax | 831-747-1095
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ROBERT SWANSON
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Credential | PHD
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Telephone | 831-402-3838
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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 | CA27001
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License Number State | CA
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