Provider Demographics
NPI:1598492423
Name:THE MIND INSTITUTE PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:THE MIND INSTITUTE PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:833-345-8444
Mailing Address - Street 1:32395 CLINTON KEITH RD STE A200
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7568
Mailing Address - Country:US
Mailing Address - Phone:760-217-4799
Mailing Address - Fax:833-345-8444
Practice Address - Street 1:32395 CLINTON KEITH RD STE A200
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7568
Practice Address - Country:US
Practice Address - Phone:833-345-8444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty