Organization
BODY MIND SPIRIT IOP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MARTIN PH.D (CEO)
(949) 247-7377
Entity
Organization
Contact information
Practice address
665 CAMINO DE LOS MARES STE 104, SAN CLEMENTE, CA 92673
(949) 248-7377
(866) 805-2796
Mailing address
665 CAMINO DE LOS MARES STE 104, SAN CLEMENTE, CA 92673-2840
(949) 248-7377
(866) 805-2796
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY9840
CA
Other
Enumeration date
09/25/2014
Last updated
08/24/2018
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