Provider Demographics
NPI:1215696349
Name:PSYCHOLOGICAL BEHAVIORAL TEAM INC
Entity type:Organization
Organization Name:PSYCHOLOGICAL BEHAVIORAL TEAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BIMBELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FNP, PMHNP
Authorized Official - Phone:805-626-0325
Mailing Address - Street 1:2625 TOWNSGATE RD STE 330
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5749
Mailing Address - Country:US
Mailing Address - Phone:805-626-0325
Mailing Address - Fax:
Practice Address - Street 1:2625 TOWNSGATE RD STE 330
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5749
Practice Address - Country:US
Practice Address - Phone:805-626-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty