Psychdoc Inc, a Professional Psychology Corporation

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PSYCHDOC INC, A PROFESSIONAL PSYCHOLOGY CORPORATION

Practice address

2650 Camino del Rio N Ste 108
San Diego, CA 92108-1631

Phone

(877) 815-8845

NPI assigned

Aug 28, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jessica M Stevens, PHDNPI 1659498459

Title

Ceo

Phone

(877) 815-8845

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Marie Stevens, PHD

  • Psychologist
  • Carlsbad, CA
  • NPI 1659498459
  NPD Authorized official
• Michelle L Bales, PSY.D.

  • Psychologist
  • San Diego, CA
  • NPI 1427274562
  NPD

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1992318893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PALOMAR AIRPORT RD STE 214-16",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920114402",
            "telephone_number": "877-815-8845",
            "fax_number": "833-282-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 CAMINO DEL RIO N STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081631",
            "telephone_number": "877-815-8845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Palomar Airport Rd Ste 214-26",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920114402",
            "country_code": "US",
            "telephone_number": "877-815-8845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHDOC INC, A PROFESSIONAL PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-815-8845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.