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General NPI Number Information
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NPI Number | 1962124941
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Entity Type | Organization
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Legal Business Name | BELLATOR PSYCHOLOGICAL AND CONSULTANTS CORPORATION
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 6117 BROCKTON AVE STE 202
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City | RIVERSIDE
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State | CA
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Zip | 92506-2207
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Country | US
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Telephone | 951-224-9418
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Fax |
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Provider Business Mailing Address
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Address Line | 8799 BALBOA AVE STE 255
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City | SAN DIEGO
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State | CA
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Zip | 92123-1581
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Country | US
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Telephone | 619-791-8610
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Fax | 951-224-9900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE DABDOUB
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Credential | PSY.D.
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Telephone | 858-583-6197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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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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