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General NPI Number Information
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NPI Number | 1376405464
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Entity Type | Organization
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Legal Business Name | EMERGENT MIND PSYCHOLOGY, PC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 8775 AERO DR STE 238
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City | SAN DIEGO
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State | CA
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Zip | 92123-1756
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Country | US
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Telephone | 619-752-4244
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Fax |
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Provider Business Mailing Address
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Address Line | 6270 VAN BUREN BLVD
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City | RIVERSIDE
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State | CA
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Zip | 92503-2024
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DUSHYANT MAKADIA
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Credential | PHD
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Telephone | 951-314-1824
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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 |
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License Number State |
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