=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952614372
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALLEY PSYCHOLOGICAL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2010
-----------------------------------------------------
Last Update Date | 07/15/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1850 W. MAIN ST., STE B
-----------------------------------------------------
City | EL CENTRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-352-9090
-----------------------------------------------------
Fax | 760-352-9920
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1850 W. MAIN ST., STE B
-----------------------------------------------------
City | EL CENTRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-352-9090
-----------------------------------------------------
Fax | 760-352-9920
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. DARLENE P. HOYT
-----------------------------------------------------
Credential | PH.D
-----------------------------------------------------
Telephone | 760-352-9090
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | PSY9524
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------