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General NPI Number Information
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NPI Number | 1558259002
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Entity Type | Organization
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Legal Business Name | FOUNDRY MENTAL HEALTH PSYCHOLOGY GROUP
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 39583 CALADIUM DR
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City | TEMECULA
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State | CA
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Zip | 92591-0363
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Country | US
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Telephone | 818-251-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 39583 CALADIUM DR
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City | TEMECULA
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State | CA
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Zip | 92591-0363
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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 | ELI MATTHEW VANDUSEN
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Credential | PSY.D., LMFT
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Telephone | 818-251-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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