NPIMap

Organization Active NPI

San Diego Psychological & Educational Services Inc

  • Clinical Psychologist
  • Poway, CA
National Provider Identifier
1548520471
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15959 Issued in CA
Legal business name
SAN DIEGO PSYCHOLOGICAL & EDUCATIONAL SERVICES INC
Doing business as
None
Practice address
13525 Midland Rd
Suite J
Poway, CA 92064-4771
Phone
(760) 789-7173
Fax
(760) 230-1450
NPI assigned
May 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Dr. Cyrus Nakhshab, PH.D
Title
Owner
Phone
(760) 519-2510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY15959 CA Primary

Addresses

Primary practice location

13525 Midland Rd
Suite J
Poway, CA 92064-4771

Mailing address

13525 Midland Rd Ste J
Poway, CA 92064-4772
Phone (760) 519-2510

Other names 1

  • None Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1548520471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 MIDLAND RD STE J",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644772",
            "telephone_number": "760-519-2510",
            "fax_number": "760-230-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13525 MIDLAND RD",
            "address_2": "SUITE J",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644771",
            "telephone_number": "760-789-7173",
            "fax_number": "760-230-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO PSYCHOLOGICAL & EDUCATIONAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "NAKHSHAB",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-519-2510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.