Provider Demographics
NPI:1568981678
Name:ROSS PSYCHOLOGY
Entity Type:Organization
Organization Name:ROSS PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST/OWNE
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:SCIMONE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-361-2229
Mailing Address - Street 1:4883 RONSON COURT
Mailing Address - Street 2:SUITE K
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111
Mailing Address - Country:US
Mailing Address - Phone:858-361-2229
Mailing Address - Fax:858-952-0516
Practice Address - Street 1:4883 RONSON COURT
Practice Address - Street 2:SUITE K
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111
Practice Address - Country:US
Practice Address - Phone:858-361-2229
Practice Address - Fax:858-952-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22304103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty