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Contact Information

INTRICATE MIND INSTITUTE, LLC
3990 OLD TOWN AVE STE A207
SAN DIEGO, CA92110-2967
 Phone: 858-205-9809
 Fax: 858-205-9809
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for INTRICATE MIND INSTITUTE, LLC

NPI # 1457638124
LBN Legal business name INTRICATE MIND INSTITUTE, LLC
Authorized official MARY BAKER-ERICZEN - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 11/09/2011
Last updated 11/09/2011 - About 15 years ago
Identifiers
CA License # PSY17553
CA License # PSY23448
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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