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Contact Information

BALES PSYCHOLOGY CLINIC
3252 HOLIDAY CT STE 114
LA JOLLA, CA92037-0027
 Phone: 619-380-0508
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Adolescent and Children Mental Health

261QM0855X
 

Adult Mental Health

261QM0850X
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BALES PSYCHOLOGY CLINIC

NPI # 1003663220
LBN Legal business name BALES PSYCHOLOGY CLINIC
Authorized official SHAMIRON BALES - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/06/2024
Last updated 02/19/2025 - More than a year ago
Identifiers
CA Other 1962266973 103T00000X
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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