Provider Demographics
NPI:1811683089
Name:PSYCHOLOGICAL TESTING CENTER OF CALIFORNIA
Entity type:Organization
Organization Name:PSYCHOLOGICAL TESTING CENTER OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEIBERMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:424-262-9445
Mailing Address - Street 1:1730 S AMPHLETT BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2712
Mailing Address - Country:US
Mailing Address - Phone:424-262-9445
Mailing Address - Fax:
Practice Address - Street 1:1730 S AMPHLETT BLVD STE 209
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2712
Practice Address - Country:US
Practice Address - Phone:424-262-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty