| Regents Of University Of California | |
|
19722 Macarthur Blvd Uci-child Development Center Irvine CA 92612-2404 | |
| (949) 824-1800 | |
| (949) 824-1811 |
| Full Name | Regents Of University Of California |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 19722 Macarthur Blvd, Irvine, California |
| Authorized Official Name and Position | Tim L Wigal (CLINICAL PROFESSOR) |
| Authorized Official Contact | 9498241812 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regents Of University Of California 19722 Macarthur Blvd Uci-child Development Center Irvine CA 92612-2404 Ph: (949) 824-1800 | Regents Of University Of California 19722 Macarthur Blvd Uci-child Development Center Irvine CA 92612-2404 Ph: (949) 824-1800 |
| NPI Number | 1912186628 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 11/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912186628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | PSY14209 (California) | Primary |
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