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1151 Dove St Suite 115 Newport Beach CA 92660-2840 | |
| (949) 201-5779 | |
| (877) 209-7251 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1151 Dove St, Newport Beach, California |
| Authorized Official Name and Position | Adrienne Elizabeth Pasek (SECRETARY) |
| Authorized Official Contact | 9492015779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1151 Dove St Suite 115 Newport Beach CA 92660-2840 Ph: (949) 201-5779 | 1151 Dove St Suite 115 Newport Beach CA 92660-2840 Ph: (949) 201-5779 |
| NPI Number | 1841543964 |
|---|---|
| Provider Enumeration Date | 10/26/2012 |
| Last Update Date | 06/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841543964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY23321 (California) | Primary |
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