Provider Demographics
NPI:1295272607
Name:DYNAMIC INTERVENTIONS, INC.
Entity type:Organization
Organization Name:DYNAMIC INTERVENTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CAGS, LEP
Authorized Official - Phone:661-257-1254
Mailing Address - Street 1:28494 WESTINGHOUSE PL
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-0930
Mailing Address - Country:US
Mailing Address - Phone:661-257-1254
Mailing Address - Fax:
Practice Address - Street 1:28494 WESTINGHOUSE PL
Practice Address - Street 2:SUITE 208
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0930
Practice Address - Country:US
Practice Address - Phone:661-257-1254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP 3026103TS0200X
CALCSW 722751041C0700X
CALMFT 44098106H00000X
CALEP 2819103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty