Psychological Enrichment Center | |
2900 Bristol St Suite A108 Costa Mesa CA 92626-5981 | |
(714) 432-0042 | |
Not Available |
Full Name | Psychological Enrichment Center |
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Speciality | Psychologist - Clinical |
Location | 2900 Bristol St, Costa Mesa, California |
Authorized Official Name and Position | Paul Sullivan (PRESIDENT/PSYCHOLOGIST) |
Authorized Official Contact | 7144320042 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Psychological Enrichment Center 2900 Bristol St Suite A108 Costa Mesa CA 92626-5981 Ph: (714) 432-0042 | Psychological Enrichment Center 2900 Bristol St Suite A108 Costa Mesa CA 92626-5981 Ph: (714) 432-0042 |
NPI Number | 1942409255 |
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Provider Enumeration Date | 07/16/2007 |
Last Update Date | 07/16/2007 |
Identifier | Type | State | Issuer |
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1942409255 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PSY18437 (California) | Primary |
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