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SAN DIEGO CENTER FOR NEUROFEEDBACK NPI 1851731079


NPI Information

NPI: 1851731079
Provider Name: SAN DIEGO CENTER FOR NEUROFEEDBACK
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 05D2277194

Address:
12064 WOODSIDE AVE STE 105
LAKESIDE, CA
ZIP 92040
Phone: (619) 448-1216
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SAN DIEGO CENTER FOR NEUROFEEDBACK is a clinical psychologist in Lakeside, CA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SAN DIEGO CENTER FOR NEUROFEEDBACK NPI is 1851731079. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12064 WOODSIDE AVE STE 105
LAKESIDE, CA
ZIP 92040-951
Phone: (619) 448-1216

The provider's authorized official is Christiana Katarina Silva .
The authorized official title is President and has the following contact phone number (619) 448-1216.

The CLIA number assigned to this NPI record is 05D2277194 - other - inpatient drug/alcohol de with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/2/2013 and was last updated on 7/2/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalPSY 21878CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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