Provider Demographics
NPI:1477103356
Name:ORGANIZATIONAL MIND GROUP, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:ORGANIZATIONAL MIND GROUP, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:WINOGRAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:916-254-8982
Mailing Address - Street 1:34091 CALLE LA PRIMAVERA UNIT B
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2694
Mailing Address - Country:US
Mailing Address - Phone:916-254-8982
Mailing Address - Fax:
Practice Address - Street 1:34091 CALLE LA PRIMAVERA UNIT B
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2694
Practice Address - Country:US
Practice Address - Phone:916-254-8982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty