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General NPI Number Information
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NPI Number | 1407219405
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR INTEGRAL PSYCHOLOGY
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 1000 S FREMONT AVE UNIT 60 A-1, 1219
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City | ALHAMBRA
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State | CA
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Zip | 91803-8886
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Country | US
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Telephone | 626-607-6995
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S FREMONT AVE UNIT 60 A-1, 1219
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City | ALHAMBRA
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State | CA
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Zip | 91803-8886
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Country | US
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Telephone | 626-607-6995
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THOMAS JOSEPH SCHACATANO
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Credential | PSYD
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Telephone | 626-607-6995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY 21881
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License Number State | CA
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