Provider Demographics
NPI:1427458710
Name:SAN DIEGO BRAINWORKS PSYCHOLOGY & NEUROPSYCHOLOGY SERVICES
Entity type:Organization
Organization Name:SAN DIEGO BRAINWORKS PSYCHOLOGY & NEUROPSYCHOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMKLOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:661-340-1560
Mailing Address - Street 1:5130 LONG BRANCH AVE
Mailing Address - Street 2:A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-2034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11512 EL CAMINO REAL
Practice Address - Street 2:350
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2087
Practice Address - Country:US
Practice Address - Phone:661-340-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty