1326108507 NPI number — FARKAS & SAALINGER PSYCHOLOGY CORP

Table of content: DR. TAMMY JEAN CHIHOS MANTZOURIS MD (NPI 1669644001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326108507 NPI number — FARKAS & SAALINGER PSYCHOLOGY CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARKAS & SAALINGER PSYCHOLOGY CORP
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:
6
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:
1326108507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6046 CORNERSTONE COURT W
Provider Second Line Business Mailing Address:
#113
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-453-4315
Provider Business Mailing Address Fax Number:
858-453-5690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6046 CORNERSTONE CT W
Provider Second Line Business Practice Location Address:
#113
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92121-4758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-453-4315
Provider Business Practice Location Address Fax Number:
858-453-5690
Provider Enumeration Date:
12/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SAALINGER
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
858-453-4315

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  370101AP , 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)





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