Provider Demographics
NPI:1619735099
Name:CHILD PSYCHOLOGY CENTER, INC.
Entity Type:Organization
Organization Name:CHILD PSYCHOLOGY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-480-5150
Mailing Address - Street 1:2945 HARDING ST STE 205
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1818
Mailing Address - Country:US
Mailing Address - Phone:858-480-5150
Mailing Address - Fax:
Practice Address - Street 1:2945 HARDING ST STE 205
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1818
Practice Address - Country:US
Practice Address - Phone:858-480-5150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty