Provider Demographics
NPI:1215509898
Name:WITHIN SIGHT PSYCHOLOGICAL AND INTEGRATED SOLUTIONS, INC
Entity type:Organization
Organization Name:WITHIN SIGHT PSYCHOLOGICAL AND INTEGRATED SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF GROUP
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:FANALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-366-7973
Mailing Address - Street 1:3960 W POINT LOMA BLVD STE H56720
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4907 MORENA BLVD STE 1416
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-7393
Practice Address - Country:US
Practice Address - Phone:858-366-7973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty