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Bales Psychology Clinic

Psychologist, Clinical in La Jolla, CA. Organization (NPI-2).

NPI number1003663220
StatusActive
Last updated in NPPESFeb 19, 2025

Details

NPI
1003663220
Entity type
Organization (NPI-2)
Legal business name
Bales Psychology Clinic
Organization subpart
No
Enumeration date
May 6, 2024
Certification date
Feb 19, 2025
Last updated
Feb 19, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical––Yes
103T00000X Psychologist––
103TC2200X Psychologist, Clinical Child & Adolescent––
103TM1800X Psychologist, Intellectual & Developmental Disabilities––
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––
261QM0850X Clinic/Center, Adult Mental Health––
261QM0855X Clinic/Center, Adolescent and Children Mental Health––

Practice location

3252 Holiday Ct Ste 114
La Jolla, CA 92037-0027

Phone 619-380-0508

Mailing address

3252 Holiday Ct Ste 114
La Jolla, CA 92037-0027

Phone 619-380-0508

Authorized official

Shamiron Bales
Owner
6195996797

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