Provider Demographics
NPI:1548582364
Name:APPLIED PSYCHOLOGICAL HEALTH INC
Entity Type:Organization
Organization Name:APPLIED PSYCHOLOGICAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KABBAN-MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-770-7192
Mailing Address - Street 1:6816 CIBOLA RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-1707
Mailing Address - Country:US
Mailing Address - Phone:619-770-7192
Mailing Address - Fax:619-393-1770
Practice Address - Street 1:1224 10TH ST STE 201A
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-3420
Practice Address - Country:US
Practice Address - Phone:619-770-7192
Practice Address - Fax:619-393-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-21
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21837251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health