| Integrated Psychological Services A Professional Corporation | |
|
28202 Cabot Rd Ste 300 Laguna Niguel CA 92677-1249 | |
| (949) 280-3585 | |
| (949) 831-2439 |
| Full Name | Integrated Psychological Services A Professional Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 28202 Cabot Rd Ste 300, Laguna Niguel, California |
| Authorized Official Name and Position | Maria M. Petrosino (PRESIDENT) |
| Authorized Official Contact | 9492803585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Psychological Services A Professional Corporation Po Box 6546 Laguna Niguel CA 92607-6546 Ph: (949) 365-0309 | Integrated Psychological Services A Professional Corporation 28202 Cabot Rd Ste 300 Laguna Niguel CA 92677-1249 Ph: (949) 280-3585 |
| NPI Number | 1588639918 |
|---|---|
| Provider Enumeration Date | 02/20/2006 |
| Last Update Date | 02/09/2023 |
| Certification Date | 02/09/2023 |
| Medicare PECOS PAC ID | 8325215742 |
|---|---|
| Medicare Enrollment ID | O20120125000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588639918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
| Provider Name | Maria M Petrosino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124093554 PECOS PAC ID: 4688831894 Enrollment ID: I20120131000199 |
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