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General NPI Number Information
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NPI Number | 1912637521
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Entity Type | Organization
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Legal Business Name | PACIFIC COGNITIVE HEALTH, A PROFESSIONAL PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 3626 SACRAMENTO ST STE 4
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1720
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Country | US
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Telephone | 352-340-3897
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 210160
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-0160
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Country | US
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Telephone |
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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. PAUL MANGAL
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Credential | PH.D.
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Telephone | 352-340-3897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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