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Dr. Keith Park
Psychologist in Calimesa, California
NPI 1710101092

Keith Park is a Psychologist based in Yucaipa, CA. Keith Park practices in Calimesa, CA. The NPI Number for Keith Park is 1710101092 and holds a License No. 0085201 (California).

The current practice location address for Keith Park is 908 Park Ave, Calimesa, CA and can be reached out via phone at 909-518-3886 and via fax at 909-790-9333.

Location: 908 Park Ave, Calimesa, CA, 92399-1435
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710101092
Provider Name
Keith Park
Credential
Provider Entity Type
Individual
Gender
Male
Address
908 Park Ave, Calimesa, CA, 92399-1435
Phone Number
909-518-3886
Fax Number
909-790-9333
Provider Enumeration Date
04/11/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
908 Park Ave
City
Calimesa
State
California
Zip
92320-1148
Phone Number
909-518-3886
Fax Number
909-790-9333
person
Provider Business Mailing Address Details
Address
908 Park Ave
City
Calimesa
State
California
Zip
92320-1148
Phone Number
909-518-3886
Fax Number
909-790-9333
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
PSY 18884 (California)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
-
Taxonomy
103T00000X
License No.
0085201 (New Mexico)
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
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