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San Diego Professional Group, P. C.
Addiction Medicine (Psychiatry & Neurology) Physician in Aliso Viejo, California
NPI 1699220004

San Diego Professional Group, P. C. is an Addiction Medicine (Psychiatry & Neurology) Physician based in Brentwood, CA and is specialized in Addiction Medicine. San Diego Professional Group, P. C. practices in Aliso Viejo, CA. The NPI Number for San Diego Professional Group, P. C. is 1699220004 and holds a License No. 20A6119 (California).

The current practice location address for San Diego Professional Group, P. C. is 24552 Pacific Park Dr, Aliso Viejo, CA and can be reached out via phone at 615-727-8416 and via fax at 615-457-8094.

Location: 24552 Pacific Park Dr, Aliso Viejo, CA, 37027-7514
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699220004
Provider Name
San Diego Professional Group, P. C.
Credential
Provider Entity Type
Organization
Address
24552 Pacific Park Dr, Aliso Viejo, CA, 37027-7514
Phone Number
615-727-8416
Fax Number
615-457-8094
Provider Enumeration Date
08/16/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
24552 Pacific Park Dr
City
Aliso Viejo
State
California
Zip
92656-3033
Phone Number
615-727-8416
Fax Number
615-457-8094
person
Provider Business Mailing Address Details
Address
24552 Pacific Park Dr
City
Aliso Viejo
State
California
Zip
92656-3033
Phone Number
615-727-8416
Fax Number
615-457-8094
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Addiction (Substance Use Disorder)
Taxonomy
103TA0400X
License No.
20A6119 (California)
Definition
A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Addiction Medicine
Taxonomy
207RA0401X
License No.
20A6119 (California)
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Addiction Medicine
Taxonomy
2084A0401X
License No.
20A6119 (California)
Definition
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
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