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General NPI Number Information
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NPI Number | 1669231908
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Entity Type | Organization
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Legal Business Name | SOUL IN MIND PSYCHOLOGICAL SERVICES INC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 26266 MERIDIAN ST
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City | HEMET
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State | CA
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Zip | 92544-6486
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Country | US
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Telephone | 951-585-0397
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Fax | 951-795-4560
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Provider Business Mailing Address
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Address Line | 26266 MERIDIAN ST
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City | HEMET
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State | CA
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Zip | 92544-6486
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Country | US
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Telephone | 951-585-0397
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Fax | 951-795-4560
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Authorized Official
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Title or Position | CEO
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Name | DR. JENNIFER SANDOVAL
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Credential | PHD
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Telephone | 857-217-1141
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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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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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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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