SAN DIEGO PSYCHOLOGICAL CENTER INC. (NPI# 1083003586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083003586 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO PSYCHOLOGICAL CENTER INC. |
| Other Organization Name | SDPC |
| Practice Address |
15525 Pomerado Rd Suite B3 Poway CA 92064-2435 |
| Practice Telephone | 7606076463 |
| Practice Fax Number | 7606073433 |
| Mailing Telephone | 7606076463 |
| Mailing Fax Number | 7606073433 |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2017-01-10 |
| Authorized Official Name | DR. BANAFSHEH PEZESHK (CEO) |
| Authorized Official Telephone | 7606076463 |
| Authorized Official Credential | PSY.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 22844 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PERSONAL NPI | 1184959009 | 01 |
| Other Name | Type Code |
|---|---|
| SDPC | Other Name - Individual/Organization |
| Street Address |
15525 POMERADO RD SUITE B3 |
| City | POWAY |
| State | CA |
| Zip Code | 92064-2435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073519955 | Debra Joan Abel | Audiologist | 15525 Pomerado Rd, E-1, Poway, CA 92064-2435 | 2005-06-24 |
| 1619412806 | Waves, A Psychological Corporation | Psychologist | 15525 Pomerado Rd, Suite C-5, Poway, CA 92064-2435 | 2016-12-27 |
| 1871994905 | Tracy Daly | Dietitian, Registered | 15525 Pomerado Rd, Suite B-1, Poway, CA 92064-2435 | 2014-09-08 |
| 1144655507 | Blue Skies Behavioral Health | Clinic/Center | 15525 Pomerado Rd, Suite B-1, Poway, CA 92064-2435 | 2013-09-04 |
| 1295088334 | San Diego Diagnostic Radiology Medical Group, Inc. | Clinic/Center | 15525 Pomerado Rd, Suite E2, Poway, CA 92064-2435 | 2012-10-25 |
| 1598047086 | Sarah L Jacobs-paul | Counselor | 15525 Pomerado Rd, Suite C-5, Poway, CA 92064-2435 | 2011-09-12 |
| 1568750438 | Amanda Louise Peeler | Physical Therapist | 15525 Pomerado Rd, Ste D4, Poway, CA 92064-2435 | 2011-07-13 |
| 1952694408 | Erika Swift Holtermann | Psychologist | 15525 Pomerado Rd, Suite B-1, Poway, CA 92064-2435 | 2011-05-17 |
| 1124310917 | Cpte Physical Therapy Professional Corporation | Physical Therapist | 15525 Pomerado Rd, Ste D4, Poway, CA 92064-2435 | 2011-05-11 |
| 1093006512 | Arch Health Partners | Audiologist | 15525 Pomerado Rd, Sute C-1, Poway, CA 92064-2435 | 2011-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194357384 | Prabha Choudhary | Student in an Organized Health Care Education/Training Program | 17555, Corte Lomas Verdes, Poway, CA 92064 | 2020-02-06 |
| 1770143968 | Theresa Marie Morales | In Home Supportive Care | 15352 Running Deer Trl, Poway, CA 92064 | 2019-06-19 |
| 1689230997 | Jaclyn Miller | Audiologist | Health Medical Group, 15525 Pomerado Road Suite C-1, Poway, CA 92064 | 2019-05-13 |
| 1205306842 | Angelita Fuentes | Behavior Technician | 12975 Brookprinter Place Suite 250, Poway, CA 92064 | 2018-11-27 |
| 1396235271 | Michael Cutler, M.d., P.C. | Clinic/Center | 12285 Scripps Poway Pkwy Ste 103, Poway, CA 92064 | 2018-05-16 |
| 1720576671 | Jodi A Mcgrady Dmd, Ms, Adc | Dentist | 12350 Oak Knoll Rd, Poway, CA 92064 | 2018-04-26 |
| 1295237139 | Michelle J. Beaupre | Social Worker | 204 Poway Rd., Poway, CA 92064 | 2018-03-07 |
| 1669918165 | Restore Detox Centers | Substance Abuse Rehabilitation Facility | 14099 Sky Mountain Trail, Poway, CA 92064 | 2017-01-09 |
| 1205382561 | Nightingale Meyou | Pharmacist | 5615 Pomerado Rd, Poway, CA 92064 | 2016-08-28 |
| 1578017232 | Elan Lee | Dentist | 13035 Pomerado Road Suite B, Poway, CA 92064 | 2016-08-11 |
| Find all providers in zip 92064 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174847529 | San Diego Psychological & Edcuation | Psychologist | 13525 Midland Rd., Suite J, Poway, CA 92064-4772 | 2010-03-15 |
| 1063518264 | Shelby Jean Thorpe | Psychologist | 13669 Somerset Rd, Poway, CA 92064-4034 | 2006-09-15 |
| 1336109032 | Cyrus Nakhshab | Psychologist | 13525 Midland Road, Suite J, Poway, CA 92065 | 2006-03-25 |
| 1154849933 | Camilla Ruth Williams | Psychologist | 15525 Pomerado Rd Ste C5, Poway, CA 92064-2426 | 2017-08-31 |
| 1164885869 | Lauren Elisabeth Pichard | Psychologist | 15644 Pomerado Rd, Suite 305, Poway, CA 92064-2400 | 2016-03-30 |
| 1427291921 | Amy Balete | Psychologist | 15525 Pomerado Rd Ste B1, Poway, CA 92064-2425 | 2009-04-14 |
| 1982709424 | Hayley Lynn Silverman | Psychologist | 14781 Pomerado Rd, #152, Poway, CA 92064-2802 | 2006-09-13 |
| 1861508921 | John Lee Evans | Psychologist | 15525 Pomerado Rd, Suite E-4, Poway, CA 92064-2435 | 2006-08-22 |
| 1578573911 | Erin Elizabeth Brody | Psychologist | 15525 Pomerado Rd, Suite E3, Poway, CA 92064 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306690 | Eileen Kay Laughman | Psychologist | 24545 Town Center Dr Apt 5406, Valencia, CA 91355-1397 | 2020-11-08 |
| 1194324954 | Rachel Charman | Psychologist | 1001 Dove St Ste 110, Newport Beach, CA 92660-2845 | 2020-10-22 |
| 1700485760 | Melissa Ernestine Munoz | Psychologist | 353 H St # 1517, Chula Vista, CA 91910-5501 | 2020-10-21 |
| 1235737669 | Maha Nasrallah-babenko | Psychologist | 33442 Valley View Ct, Dana Point, CA 92629-1515 | 2020-10-16 |
| 1689272544 | Kaleidoscope Solutions Family Therapy | Psychologist | 25876 The Old Road, #85, Stevenson Ranch, CA 91381 | 2020-10-13 |
| 1992302814 | Sheena Gill | Psychologist | 2501 E Chapman Ave Ste 265, Fullerton, CA 92831-3108 | 2020-10-04 |
| 1255948600 | Kesha Patrice | Psychologist | 939 Ellis St, San Francisco, CA 94109-7714 | 2020-09-29 |
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1376159541 | Jill Caryn Campbell | Psychologist | 342 Ocho Rios Way, Oak Park, CA 91377-5541 | 2020-09-22 |
| 1225644487 | Brock Louis Pistel | Psychologist | 939 Ellis St Fl 67, San Francisco, CA 94109-7714 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SAN DIEGO PSYCHOLOGICAL CENTER INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.