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General NPI Number Information
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NPI Number | 1902074693
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL MANAGEMENT RESOURCES, INC.
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 9340 CARMEL MOUNTAIN RD SUITE F
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City | SAN DIEGO
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State | CA
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Zip | 92129-2161
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Country | US
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Telephone | 858-449-1953
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Fax | 858-538-1661
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Provider Business Mailing Address
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Address Line | 9340 CARMEL MOUNTAIN RD SUITE F
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City | SAN DIEGO
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State | CA
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Zip | 92129-2161
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Country | US
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Telephone | 858-449-1953
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Fax | 858-538-1661
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL M BLUMBERG
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Credential | PH.D.
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Telephone | 858-449-1953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY10834
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License Number State | CA
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