NPIMap

Organization Active NPI

Mindful Neuropsychology Professional Corporation

  • Psychologist
  • San Diego, CA
National Provider Identifier
1366717845
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20782 Issued in CA
Legal business name
MINDFUL NEUROPSYCHOLOGY PROFESSIONAL CORPORATION
Practice address
9255 Towne Centre Dr Ste 875
San Diego, CA 92121-3064
Phone
(858) 888-2668
Fax
(858) 455-5556
NPI assigned
Mar 15, 2012
Last updated
Mar 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Dr. Amanda Han, PSY.D.NPI 1548397110
Title
President
Phone
(626) 589-6155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 20782 CA Primary

Addresses

Primary practice location

9255 Towne Centre Dr Ste 875
San Diego, CA 92121-3064

Mailing address

9255 Towne Centre Dr Ste 875
San Diego, CA 92121-3064
Phone (858) 888-2668

National Provider Directory

National Provider Directory

Locations

9255 Towne Centre Dr
Ste 875
San Diego, CA 92121
Phone (858) 352-8239

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1366717845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9255 TOWNE CENTRE DR STE 875",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213064",
            "telephone_number": "858-888-2668",
            "fax_number": "858-455-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9255 TOWNE CENTRE DR STE 875",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213064",
            "telephone_number": "858-888-2668",
            "fax_number": "858-455-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL NEUROPSYCHOLOGY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-589-6155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "20782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.