Basic Information
| Provider Information | |||||||||
| NPI: | 1235371477 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COHEALTH PSYCHOLOGY SERVICES, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4901 MORENA BLVD | ||||||||
| Address2: | SUITE109 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921173423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582723992 | ||||||||
| FaxNumber: | 8582723804 | ||||||||
| Practice Location | |||||||||
| Address1: | 3800 CENTRAL DR | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760212683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172836604 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2009 | ||||||||
| LastUpdateDate: | 04/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | CASCIANI | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8582723992 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TH0100X | 24830 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Health Service |
No ID Information.