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General NPI Number Information
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NPI Number | 1982289740
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Entity Type | Organization
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Legal Business Name | MARK HEYMAN PSYCHOLOGIST INC
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Dates
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Enumeration Date | 03/13/2021
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Last Update Date | 03/13/2021
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Provider Practice Location Address
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Address Line | 12526 HIGH BLUFF DR STE 300
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City | SAN DIEGO
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State | CA
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Zip | 92130-2067
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Country | US
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Telephone | 858-461-9295
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Fax | 858-751-7582
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Provider Business Mailing Address
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Address Line | 4374 CHELFORD ST
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City | SAN DIEGO
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State | CA
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Zip | 92117-4130
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Country | US
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Telephone | 858-461-9295
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Fax | 858-751-7582
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Authorized Official
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Title or Position | CEO
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Name | DR. MARK HEYMAN
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Credential | PHD
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Telephone | 858-461-9295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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