Provider Demographics
NPI:1851738934
Name:GREGORY CARINCI PSYCHOLOGY INC
Entity Type:Organization
Organization Name:GREGORY CARINCI PSYCHOLOGY INC
Other - Org Name:OPTIMUM BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARINCI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, BCBA-D
Authorized Official - Phone:619-297-4300
Mailing Address - Street 1:3702 RUFFIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1893
Mailing Address - Country:US
Mailing Address - Phone:619-297-4300
Mailing Address - Fax:619-297-4400
Practice Address - Street 1:3702 RUFFIN RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1893
Practice Address - Country:US
Practice Address - Phone:619-297-4300
Practice Address - Fax:619-297-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22311251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health