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General NPI Number Information
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NPI Number | 1508204082
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Entity Type | Organization
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Legal Business Name | VALLEY PSYCHOLOGICAL CENTER
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 1850 W MAIN ST SUITE B
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City | EL CENTRO
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State | CA
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Zip | 92243-2198
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Country | US
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Telephone | 760-352-9090
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Fax | 760-352-9920
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Provider Business Mailing Address
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Address Line | 3411 3RD AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-4906
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Country | US
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Telephone | 619-203-5336
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MRS. STACEY HOYT
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Credential | PHD.
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Telephone | 619-203-5336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PSY16717
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PSY16717
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY16717
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY16717
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | PSY16717
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY16717
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | PSY16717
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY16717
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License Number State | CA
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