Provider Demographics
NPI:1255907812
Name:MAJESTIC PSYCHOLOGICAL SERVICES INC
Entity type:Organization
Organization Name:MAJESTIC PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MAJESTIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-900-2991
Mailing Address - Street 1:340 G ST STE A
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4184
Mailing Address - Country:US
Mailing Address - Phone:916-900-2991
Mailing Address - Fax:
Practice Address - Street 1:340 G ST STE A
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4184
Practice Address - Country:US
Practice Address - Phone:916-900-2991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)