Provider Demographics
NPI:1598877201
Name:AFFILIATED PSYCHOLOGISTS & COUNSELORS, INC.
Entity Type:Organization
Organization Name:AFFILIATED PSYCHOLOGISTS & COUNSELORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:SULLIVAN
Authorized Official - Last Name:EVERSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-342-0612
Mailing Address - Street 1:20833 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2154
Mailing Address - Country:US
Mailing Address - Phone:408-342-0612
Mailing Address - Fax:
Practice Address - Street 1:20833 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2154
Practice Address - Country:US
Practice Address - Phone:408-342-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4771103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty