Provider Demographics
NPI:1073361580
Name:BILINGUAL PSYCHOLOGICAL AND EDUCATIONAL ASSESSMENT SPECIALISTS PLLC
Entity type:Organization
Organization Name:BILINGUAL PSYCHOLOGICAL AND EDUCATIONAL ASSESSMENT SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCANEGRA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-689-3428
Mailing Address - Street 1:5740 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4659
Mailing Address - Country:US
Mailing Address - Phone:502-689-3428
Mailing Address - Fax:
Practice Address - Street 1:357 W CENTER ST STE 3
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3236
Practice Address - Country:US
Practice Address - Phone:208-244-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty