Provider Demographics
NPI:1982114088
Name:PSYCHOLOGY CONSULTING, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:PSYCHOLOGY CONSULTING, PROFESSIONAL CORPORATION
Other - Org Name:EMBRASSE TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TWEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-560-3947
Mailing Address - Street 1:310 S TWIN OAKS VALLEY RD # 107-229
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 W VISTA WAY STE 102
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5735
Practice Address - Country:US
Practice Address - Phone:760-560-3947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCHOLOGY CONSULTING, PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-03
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122488251B00000X, 261QM0850X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health