Provider Demographics
NPI:1235993015
Name:TRI-VALLEY PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:TRI-VALLEY PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:REGEV
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:925-264-9479
Mailing Address - Street 1:739 MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6641
Mailing Address - Country:US
Mailing Address - Phone:925-264-9479
Mailing Address - Fax:
Practice Address - Street 1:739 MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6641
Practice Address - Country:US
Practice Address - Phone:925-264-9479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health