MEDICARE: JOCH PSYCHOLOGICAL CONSULTING, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1811604507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOCH PSYCHOLOGICAL CONSULTING, INC

Provider Business Mailing Address
First Line	:	13202 SANDY MOUND LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-1968
Country	:	US
Telephone Number	:	909-343-3113
Fax Number	:

Provider Business Practice Location Address
First Line	:	13202 SANDY MOUND LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-1968
Country	:	US
Telephone Number	:	909-343-3113
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	OMAGBITSE JAGHA
Credential	:
Telephone Number	:	909-343-3113

Provider Enumeration Date	:	11/01/2022
Last Update Date	:	11/01/2022

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