Provider Demographics
NPI:1669906657
Name:SPIRITUAL PSYCHOLOGIST PC
Entity type:Organization
Organization Name:SPIRITUAL PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEECH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-331-0978
Mailing Address - Street 1:PO BOX 1873
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-7873
Mailing Address - Country:US
Mailing Address - Phone:562-331-0978
Mailing Address - Fax:925-384-2372
Practice Address - Street 1:5655 SCHOONER LOOP
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505-9213
Practice Address - Country:US
Practice Address - Phone:562-331-0978
Practice Address - Fax:925-384-2372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty