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General NPI Number Information
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NPI Number | 1568931806
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Entity Type | Organization
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Legal Business Name | STACEY ANN TOBIE A PROFESSIONAL PSYCHOLOGY CORPORATION
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Dates
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Enumeration Date | 11/15/2018
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Last Update Date | 01/15/2019
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Provider Practice Location Address
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Address Line | 8253 WHITE OAK AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7671
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Country | US
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Telephone | 909-987-1997
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Fax |
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Provider Business Mailing Address
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Address Line | 8253 WHITE OAK AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7671
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Country | US
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Telephone | 909-987-1997
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STACEY ANN TOBIE
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Credential | PSYD
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Telephone | 909-987-1997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number |
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License Number State |
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