Provider Demographics
NPI:1346947991
Name:DISCOVERY PSYCHOLOGY INC
Entity Type:Organization
Organization Name:DISCOVERY PSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDUBEHERE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:619-204-1832
Mailing Address - Street 1:421 BROADWAY # 359
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-5107
Mailing Address - Country:US
Mailing Address - Phone:619-552-3218
Mailing Address - Fax:
Practice Address - Street 1:3405 KENYON STREET SUITE 202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110
Practice Address - Country:US
Practice Address - Phone:619-552-3218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty