Provider Demographics
NPI:1134783566
Name:TRUE NORTH PSYCHOLOGY, A PSYCHOLOGICAL PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:TRUE NORTH PSYCHOLOGY, A PSYCHOLOGICAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:669-244-4909
Mailing Address - Street 1:173 N MORRISON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2712
Mailing Address - Country:US
Mailing Address - Phone:669-240-1003
Mailing Address - Fax:
Practice Address - Street 1:173 N MORRISON AVE STE D
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2712
Practice Address - Country:US
Practice Address - Phone:669-342-4681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty