Provider Demographics
NPI:1174233704
Name:SUDDENLY NORMAL PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:SUDDENLY NORMAL PSYCHOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JEFFRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-722-6705
Mailing Address - Street 1:3535 LINDA VISTA DR STE 288
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-6342
Mailing Address - Country:US
Mailing Address - Phone:858-722-6705
Mailing Address - Fax:833-933-0631
Practice Address - Street 1:3535 LINDA VISTA DR. STE 288
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-6342
Practice Address - Country:US
Practice Address - Phone:858-722-6705
Practice Address - Fax:833-933-0631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty