Active Sports Psychology, Apc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PSY13159 Issued in CA

Legal business name

ACTIVE SPORTS PSYCHOLOGY, APC

Practice address

10825 Duroy CT
Tustin, CA 92782-1341

Phone

(714) 625-7784

Fax

(714) 838-0186

NPI assigned

Jan 1, 2016

Last updated

Jan 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Steven Conboy, PH.D.NPI 1780953778

Title

President

Phone

(714) 625-7784

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Robert Steven Conboy, PH.D.

  • Forensic Psychologist
  • Chino, CA
  • NPI 1780953778
  NPD (past) Authorized official

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

{
    "created_epoch": "1451606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451606400000",
    "number": "1649636903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 E 4TH ST",
            "address_2": "SUITE 134",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053940",
            "telephone_number": "714-625-7784",
            "fax_number": "714-838-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 DUROY CT",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821341",
            "telephone_number": "714-625-7784",
            "fax_number": "714-838-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SPORTS PSYCHOLOGY, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-01",
        "last_updated": "2016-01-01",
        "status": "A",
        "authorized_official_last_name": "CONBOY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-625-7784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "PSY13159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Acevedo
• Anthony Acierno, D.C.
• Acorn Telemat Nursing, Apc (Acorn TeleMAT)
• Audrey Acosta
• Luisa Acosta, SP
• Acupuncture & Vital Energy Promotion Health Center
• Chantell Denise Adams
• Marilyn Marie Adams, LMFT
• Addigo, Inc.
• Erlinda Addison, AMFT

• Community/Behavioral Health Agency in Tustin, CA
• Providers in Tustin, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2016; 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.