Organization Name: | PSYCHTOOLS PSYCHOLOGY GROUP P.C. |
NPI Number: | 1013332725 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK DOMBECK (OWNER) |
Mailing Address: | 1402 Park St Suite G Alameda |
State: | CA US |
Postal Code: | 945014554 |
Phone Number: | 5109005123 |
Fax Number: | |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 02/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY25695 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |