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Organization
PACIFIC NEUROBEHAVIORAL CLINIC: A PSYCHOLOGICAL CORPORATION
Active
Organization
PACIFIC NEUROBEHAVIORAL CLINIC: A PSYCHOLOGICAL CORPORATION
Active
Other names
Pacific Neurobehavioral Clinic, PC
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS OLSON BACHIEGA PHD (CEO)
(858) 964-0722
Entity
Organization
Contact information
Practice address
3990 OLD TOWN AVE STE C303, SAN DIEGO, CA 92110-2932
(858) 964-0722
(866) 437-0375
Mailing address
3990 OLD TOWN AVE STE C303, SAN DIEGO, CA 92110-2932
(858) 964-0722
(866) 437-0375
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
PSY22738
CA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
01/29/2014
Last updated
05/26/2026
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