Healthcare Provider Details

I. General information

NPI: 1982171716
Provider Name (Legal Business Name): MICHELE ALAYNE OKONSKI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 ARGONAUT
ALISO VIEJO CA
92656-4116
US

IV. Provider business mailing address

55 LEDGEWOOD DR
RANCHO SANTA MARGARITA CA
92688-5543
US

V. Phone/Fax

Practice location:
  • Phone: 949-682-3949
  • Fax:
Mailing address:
  • Phone: 805-358-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number16250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: