Provider Demographics
NPI:1154954303
Name:PSYCHOLOGICAL BEHAVIORAL HEALTH INC.
Entity type:Organization
Organization Name:PSYCHOLOGICAL BEHAVIORAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BIMBELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PMHNP, FNP
Authorized Official - Phone:805-284-1783
Mailing Address - Street 1:1500 PALMA DR FL 2
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6451
Mailing Address - Country:US
Mailing Address - Phone:805-626-0325
Mailing Address - Fax:888-958-5269
Practice Address - Street 1:1500 PALMA DR FL 2
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6451
Practice Address - Country:US
Practice Address - Phone:805-626-0325
Practice Address - Fax:888-958-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty