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Organization
PSYCARE INC
Active
Organization
PSYCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PARDO (CHIEF LEGAL OFFICER)
(206) 399-1493
Entity
Organization
Contact information
Practice address
4550 KEARNY VILLA RD, SUITE 116, SAN DIEGO, CA 92123-1578
(858) 279-1223
(858) 467-7161
Mailing address
4550 KEARNY VILLA RD, SUITE 116, SAN DIEGO, CA 92123-1578
(858) 279-1223
(858) 467-7161
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
028385-06
CA
103TC0700X
Clinical Psychologist
2462
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W13604
MEDICARE
CA
Enumeration date
07/03/2006
Last updated
03/04/2024
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