Healthcare Provider Details

I. General information

NPI: 1457671026
Provider Name (Legal Business Name): ERROL JAMES PHILIP PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S STATE COLLEGE BLVD STE 200
BREA CA
92821-5805
US

IV. Provider business mailing address

135 S STATE COLLEGE BLVD STE 200
BREA CA
92821-5805
US

V. Phone/Fax

Practice location:
  • Phone: 714-494-9409
  • Fax:
Mailing address:
  • Phone: 714-494-9409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number26323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: