Organization
ACTIVE SPORTS PSYCHOLOGY, APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT STEVEN CONBOY PH.D. (PRESIDENT)
(714) 625-7784
Entity
Organization
Contact information
Practice address
10825 DUROY CT, TUSTIN, CA 92782-1341
(714) 625-7784
(714) 838-0186
Mailing address
2030 E 4TH ST, SUITE 134, SANTA ANA, CA 92705-3940
(714) 625-7784
(714) 838-0186
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY13159
CA
Other
Enumeration date
01/01/2016
Last updated
01/01/2016
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