Provider Demographics
NPI:1104797398
Name:PSYCHOLOGY PARTNERS A PROF CORP
Entity type:Organization
Organization Name:PSYCHOLOGY PARTNERS A PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:951-383-4460
Mailing Address - Street 1:27349 JEFFERSON AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5610
Mailing Address - Country:US
Mailing Address - Phone:951-383-4460
Mailing Address - Fax:833-229-2302
Practice Address - Street 1:27349 JEFFERSON AVE STE 111
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5610
Practice Address - Country:US
Practice Address - Phone:951-383-4460
Practice Address - Fax:833-229-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty