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General NPI Number Information
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NPI Number | 1538025176
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Entity Type | Organization
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Legal Business Name | MIND IN MOTION PSYCHOLOGICAL SERVICES CORPORATION
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 3101 4TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-5802
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Country | US
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Telephone | 312-715-8174
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 4TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-5802
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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 | CO-OWNER
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Name | DR. CRISTINA ANTONUCCI
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Credential | PSY.D
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Telephone | 312-715-8174
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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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