=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700695590
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. CARLOS ALARID PSYD PSYCHOLOGICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2025
-----------------------------------------------------
Last Update Date | 03/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3636 4TH AVE SUITE 304
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-813-1658
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 750 OTAY LAKES RD # 1012
-----------------------------------------------------
City | CHULA VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91910-6915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-183-1658
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOLOGIST
-----------------------------------------------------
Name | DR. CARLOS ALARID
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 323-813-1658
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------