| Socal Center For Change | |
|
1110 E Chapman Ave Suite 204 Orange CA 92866-2139 | |
| (714) 453-0688 | |
| (714) 453-0691 |
| Full Name | Socal Center For Change |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 1110 E Chapman Ave, Orange, California |
| Authorized Official Name and Position | Geoffrey Phillips (PRESIDENT) |
| Authorized Official Contact | 7144530688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Socal Center For Change 1110 E Chapman Ave Suite 204 Orange CA 92866-2139 Ph: (714) 453-0688 | Socal Center For Change 1110 E Chapman Ave Suite 204 Orange CA 92866-2139 Ph: (714) 453-0688 |
| NPI Number | 1104183292 |
|---|---|
| Provider Enumeration Date | 04/13/2012 |
| Last Update Date | 04/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104183292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
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