NPIMap

Organization Active NPI

San Diego Center for Neurofeedback

  • Clinical Psychologist
  • Lakeside, CA
National Provider Identifier
1851731079
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 21878 Issued in CA
Legal business name
SAN DIEGO CENTER FOR NEUROFEEDBACK
Practice address
12064 Woodside Ave Ste 105
Lakeside, CA 92040-2951
Phone
(619) 448-1216
NPI assigned
Jul 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Christiana Katarina Silva, PH.D.
Title
President
Phone
(619) 448-1216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 21878 CA Primary

Addresses

Primary practice location

12064 Woodside Ave Ste 105
Lakeside, CA 92040-2951

Mailing address

12064 Woodside Ave Ste 105
Lakeside, CA 92040-2951
Phone (619) 448-1216

National Provider Directory

National Provider Directory
Tax ID family
San Diego Center for Neurofeedback2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1851731079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12064 WOODSIDE AVE STE 105",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920402951",
            "telephone_number": "619-448-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12064 WOODSIDE AVE STE 105",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920402951",
            "telephone_number": "619-448-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO CENTER FOR NEUROFEEDBACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "SILVA",
        "authorized_official_first_name": "CHRISTIANA",
        "authorized_official_middle_name": "KATARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-448-1216",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 21878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.