Psychtools Psychology Group P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25695 Issued in CA

Legal business name

PSYCHTOOLS PSYCHOLOGY GROUP P.C.

Practice address

1402 Park St
Suite G
Alameda, CA 94501-4554

Phone

(510) 900-5123

NPI assigned

Mar 4, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Jeffrey Vigil Dombeck, PHDNPI 1689019812

Title

President

Phone

(510) 900-5123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Jeffrey Vigil Dombeck, PH.D

  • Clinical Psychologist
  • Alameda, CA
  • NPI 1689019812
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511049600000",
    "number": "1013332725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 PARK ST STE G",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014562",
            "telephone_number": "510-900-5123",
            "fax_number": "888-974-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 PARK ST",
            "address_2": "SUITE G",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014554",
            "telephone_number": "510-900-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHTOOLS PSYCHOLOGY GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2017-11-19",
        "status": "A",
        "authorized_official_last_name": "VIGIL DOMBECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-900-5123",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Julian Prins, D.C .
• Probalance, Inc.
• Taryn Livingston Propersi, LCSW
• Gillian Alice Prose
• Ma Victoria Pauline Prospero
• Debra Lynn Puryear, PH.D.
• Natasha Ursula Pyle, BCTMB, CMT, BS
• Catherine K Pyun
• Shanzay Qaisar
• Jasmine Quinn

• Clinical Psychologist in Alameda, CA
• Providers in Alameda, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.