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General NPI Number Information
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NPI Number | 1982114088
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY CONSULTING, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 550 W VISTA WAY STE 102
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City | VISTA
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State | CA
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Zip | 92083-5735
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Country | US
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Telephone | 760-560-3947
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Fax |
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Provider Business Mailing Address
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Address Line | 310 S TWIN OAKS VALLEY RD # 107-229
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City | SAN MARCOS
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State | CA
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Zip | 92078-4303
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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 | VICE PRESIDENT
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Name | TWEE HYLER
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Credential |
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Telephone | 760-560-3947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | A122488
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | A122488
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | A122488
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License Number State | CA
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