Provider Demographics
NPI:1265633689
Name:APPLIED INTERVENTIONS & METHODOLOGIES, INC.
Entity Type:Organization
Organization Name:APPLIED INTERVENTIONS & METHODOLOGIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST, DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-492-8511
Mailing Address - Street 1:6540 LUSK BLVD STE C256
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-5795
Mailing Address - Country:US
Mailing Address - Phone:858-657-9117
Mailing Address - Fax:
Practice Address - Street 1:6540 LUSK BLVD STE C256
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-5795
Practice Address - Country:US
Practice Address - Phone:858-657-9117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18351251300000X, 251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251300000XAgenciesLocal Education Agency (LEA)
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health