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Organization

GREEN ROOM PSYCHOLOGY SERVICES INCORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NEDA KHODAPARAST PSYD, QME (CEO)
(858) 480-9118
Entity
Organization

Contact information

Practice address
5252 BALBOA AVE, SUITE 204, SAN DIEGO, CA 92117-6906
(858) 480-9118
(858) 712-9035
Mailing address
5252 BALBOA AVE, SUITE 204, SAN DIEGO, CA 92117-6906
(858) 480-9118
(858) 712-9035

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23114
CA

Other

Enumeration date
03/22/2012
Last updated
03/24/2017
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