MEDICARE: HEALTH PSYCHOLOGY CENTER, P.C.

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	PSY17137	CA

General Provider Information

NPI Number	:	1891035747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH PSYCHOLOGY CENTER, P.C.

Provider Business Mailing Address
First Line	:	2181 S EL CAMINO REAL STE 204
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6288
Country	:	US
Telephone Number	:	760-439-9331
Fax Number	:

Provider Business Practice Location Address
First Line	:	2181 S EL CAMINO REAL STE 204
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6288
Country	:	US
Telephone Number	:	760-439-9331
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHERYL ANN MACDONALD
Credential	:	PSY.D.
Telephone Number	:	760-439-9331

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	02/28/2013

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