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General NPI Number Information
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NPI Number | 1770592818
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Entity Type | Organization
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Legal Business Name | APPLIED PSYCHOLOGICAL SERVICE, INC.
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 74075 EL PASEO SUITE A-12
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City | PALM DESSERT
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State | CA
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Zip | 92260-4146
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Country | US
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Telephone | 760-346-3664
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Fax | 760-346-7117
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Provider Business Mailing Address
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Address Line | 74075 EL PASEO SUITE A-12
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City | PALM DESSERT
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State | CA
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Zip | 92260-4146
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Country | US
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Telephone | 760-346-3664
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Fax | 760-346-7117
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Authorized Official
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Title or Position | PRESIDENT AND LICENSED PSYCHOLOGIST
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Name | DR. MICHAEL CHARLES LEITMAN
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Credential | PH.D
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Telephone | 760-346-3664
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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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