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28570 Marguerite Pkwy #l-2 Mission Viejo CA 92692-3713 | |
| (949) 370-9442 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 28570 Marguerite Pkwy, Mission Viejo, California |
| Authorized Official Name and Position | Desiree Delagarza (CLINICAL PSYCHOLOGIST II) |
| Authorized Official Contact | 9493709442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
23711 Whale Cv Laguna Niguel CA 92677-1666 Ph: (949) 370-9442 | 28570 Marguerite Pkwy #l-2 Mission Viejo CA 92692-3713 Ph: (949) 370-9442 |
| NPI Number | 1578644159 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 06/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578644159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 19575 (California) | Primary |
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