Provider Demographics
NPI:1205143807
Name:PROFESSIONAL AND PERSONAL EXCELLENCE INTERNATIONAL
Entity type:Organization
Organization Name:PROFESSIONAL AND PERSONAL EXCELLENCE INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:I
Authorized Official - Last Name:RODRIGUEZ-REIMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-991-0591
Mailing Address - Street 1:3530 CAMINO DEL RIO N
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1743
Mailing Address - Country:US
Mailing Address - Phone:619-991-0591
Mailing Address - Fax:858-536-9637
Practice Address - Street 1:3530 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1743
Practice Address - Country:US
Practice Address - Phone:619-991-0591
Practice Address - Fax:858-536-9637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17124103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295836138OtherINDIVIDUAL NPI - DOLORES RODRIGUEZ-REIMANN, PH.D.
CAPSY171240Medicaid
CAPSY15825Medicaid
1154422087OtherINDIVIDUAL NPI - JOACHIM REIMANN, PH.D.
1154422087OtherINDIVIDUAL NPI - JOACHIM REIMANN, PH.D.
Q04005Medicare UPIN
CAPSY171240Medicaid
CP15825Medicare PIN