Clinic Ovis Psychological Group PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CLINIC OVIS PSYCHOLOGICAL GROUP PC

Practice address

2160 Fletcher Pkwy Ste 110
El Cajon, CA 92020-2117

Phone

(888) 983-1531

NPI assigned

Jun 19, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Cody Lind Gustaveson, PHDNPI 1790303451

Title

President

Phone

(619) 636-5020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Cody L Gustaveson, PHD

  • Clinical Psychologist
  • La Mesa, CA
  • NPI 1790303451
  Medicare reassignment NPD Authorized official
• Moe Fathi, PHD

  • Clinical Psychologist
  • El Cajon, CA
  • NPI 1952979098

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1144064775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 FLETCHER PKWY STE 110",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920202117",
            "telephone_number": "619-330-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 FLETCHER PKWY STE 110",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920202117",
            "telephone_number": "888-983-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC OVIS PSYCHOLOGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "GUSTAVESON",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "LIND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-636-5020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Clayborne
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• Jarrett Jemale Clifton, LEP
• Andrew Cline
• CLS, Inc. (Premier PHysical Therapy)
• CMC Occupational Therapy, a Professional Corporation
• Coastal Connections Therapy and Counseling Services Inc.
• Coleen Stacie Cobbs, LCSW
• Joseph E Cobbs, D.C.

• Mental Health Clinic/Center (Including Community Mental Health Center) in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.