| Active Sports Psychology, Apc | |
|
10825 Duroy Ct Tustin CA 92782-1341 | |
| (714) 625-7784 | |
| (714) 838-0186 |
| Full Name | Active Sports Psychology, Apc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10825 Duroy Ct, Tustin, California |
| Authorized Official Name and Position | Robert Steven Conboy (PRESIDENT) |
| Authorized Official Contact | 7146257784 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Sports Psychology, Apc 2030 E 4th St Suite 134 Santa Ana CA 92705-3940 Ph: (714) 625-7784 | Active Sports Psychology, Apc 10825 Duroy Ct Tustin CA 92782-1341 Ph: (714) 625-7784 |
| NPI Number | 1649636903 |
|---|---|
| Provider Enumeration Date | 01/01/2016 |
| Last Update Date | 01/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649636903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY13159 (California) | Primary |
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