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General NPI Number Information
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NPI Number | 1962958090
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Entity Type | Organization
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Legal Business Name | MISSION VALLEY PSYCHOLOGY, INC.
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2667 CAMINO DEL RIO S STE 105
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City | SAN DIEGO
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State | CA
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Zip | 92108-3763
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Country | US
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Telephone | 516-330-1102
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Fax |
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Provider Business Mailing Address
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Address Line | 9210 BRAMBLE RD
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City | LA MESA
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State | CA
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Zip | 91942-3500
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Country | US
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Telephone | 516-330-1102
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY QUIROZ
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Credential |
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Telephone | 516-330-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY27130
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License Number State | CA
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