San Diego Psychological & Edcuation

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY15959 Issued in CA

Legal business name

SAN DIEGO PSYCHOLOGICAL & EDCUATION

Practice address

13525 Midland Rd., Suite J
Poway, CA 92064-4772

Phone

(619) 789-7173

NPI assigned

Mar 15, 2010

Organization subpart

No

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

Authorized official

Name

Cyrus Nakhshab, PH.D.

Title

Owner

Phone

(619) 789-7173

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1174847529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 MIDLAND RD., SUITE J",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644772",
            "telephone_number": "619-789-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13525 MIDLAND RD., SUITE J",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644772",
            "telephone_number": "619-789-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO PSYCHOLOGICAL & EDCUATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "NAKHSHAB",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-789-7173",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Poway, CA
• Providers in Poway, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.