1780695890 NPI number — BRUCE V. FIGUERED,PH.D. A PROFESSIONALPSYCHOLOGY CORPORATION

Table of content: (NPI 1780695890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780695890 NPI number — BRUCE V. FIGUERED,PH.D. A PROFESSIONALPSYCHOLOGY CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRUCE V. FIGUERED,PH.D. A PROFESSIONALPSYCHOLOGY CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780695890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9777 VALLEY RANCH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL CAJON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92021-2347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-284-2771
Provider Business Mailing Address Fax Number:
800-334-1041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14750 EL CAMINO REAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEL MAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92014-4204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-724-2134
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FIGUERED
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
V
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
858-724-2134

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY18899 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)