Provider Demographics
NPI:1508512369
Name:AJA PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:AJA PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:AHLFELD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:916-799-3866
Mailing Address - Street 1:2530 J ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4849
Mailing Address - Country:US
Mailing Address - Phone:916-799-3866
Mailing Address - Fax:916-583-7309
Practice Address - Street 1:2530 J ST STE 310
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4849
Practice Address - Country:US
Practice Address - Phone:916-799-3866
Practice Address - Fax:916-583-7309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1952687949OtherNPI AS A SOLE PROPRIETOR