Provider Demographics
NPI:1356684724
Name:INSIGHT PSYCHOLOGICAL SERVICES CENTER, PC
Entity Type:Organization
Organization Name:INSIGHT PSYCHOLOGICAL SERVICES CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVSEPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-272-6100
Mailing Address - Street 1:4907 MORENA BLVD
Mailing Address - Street 2:SUITE 1412
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3463
Mailing Address - Country:US
Mailing Address - Phone:858-272-6100
Mailing Address - Fax:
Practice Address - Street 1:4907 MORENA BLVD
Practice Address - Street 2:SUITE 1412
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3463
Practice Address - Country:US
Practice Address - Phone:858-272-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21538103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty