OrganizationActive
Active Sports Psychology, Apc
NPI 1649636903 · Community/Behavioral Health Agency · Tustin, CA
Provider details
- NPI number
- 1649636903
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Robert Conboy, President(714) 625-7784
- License
- PSY13159 (CA)
Specialties & taxonomies
Agencies
Practice location
10825 Duroy Ct
Tustin, CA 92782-1341
Phone: (714) 625-7784
Fax: (714) 838-0186
Approximate (ZIP-level) locationGet directions
Mailing address
2030 E 4th St
Santa Ana, CA 92705-3940
Registry dates
- Enumerated
- 2016-01-01
- Last updated
- 2016-01-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.