Provider Demographics
NPI:1013368141
Name:TALK THERAPY PSYCHOLOGY CENTER, CORP.
Entity Type:Organization
Organization Name:TALK THERAPY PSYCHOLOGY CENTER, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAGOSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-205-2490
Mailing Address - Street 1:5935 CORNERSTONE CT W
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3737
Mailing Address - Country:US
Mailing Address - Phone:858-205-2490
Mailing Address - Fax:
Practice Address - Street 1:5935 CORNERSTONE CT W
Practice Address - Street 2:SUITE 125
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3737
Practice Address - Country:US
Practice Address - Phone:858-205-2490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty