Healthcare Provider Details
I. General information
NPI: 1922937853
Provider Name (Legal Business Name): DARING PATH PSYCHOLOGY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
216 N MADRONA AVE APT C
BREA CA
92821-4021
US
IV. Provider business mailing address
216 N MADRONA AVE APT C
BREA CA
92821-4021
US
V. Phone/Fax
- Phone: 657-341-0778
- Fax: 657-529-0085
- Phone: 657-341-0778
- Fax: 657-529-0085
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MAX
B.
WU
Title or Position: CLINICAL PSYCHOLOGIST/OWNER
Credential: PHD
Phone: 657-341-0778