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Organization
SHIFT: A PSYCHOLOGICAL CORPORATION
Active
Organization
SHIFT: A PSYCHOLOGICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID KYLE BOND PHD (OWNER)
(949) 329-3779
Entity
Organization
Contact information
Practice address
4063 BIRCH ST STE 220, NEWPORT BEACH, CA 92660-2241
(480) 329-0544
Mailing address
3334 E COAST HWY # 509, CORONA DEL MAR, CA 92625-2328
(480) 329-0544
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY31794
PSYCHOLOGY LICENSE
CA
Enumeration date
06/15/2020
Last updated
07/30/2020
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