Provider Demographics
NPI:1245775782
Name:HG PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HG PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LARKIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:619-302-0985
Mailing Address - Street 1:2333 1ST AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-1538
Mailing Address - Country:US
Mailing Address - Phone:619-302-0985
Mailing Address - Fax:
Practice Address - Street 1:2333 1ST AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1538
Practice Address - Country:US
Practice Address - Phone:619-302-0985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24510103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty