Healthcare Provider Details

I. General information

NPI: 1831784107
Provider Name (Legal Business Name): JENNY ELIZABETH ANN MCCARTNEY PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1352 LAFAYETTE CIR
CORONA CA
92882-6042
US

IV. Provider business mailing address

1234 W CHAPMAN AVE
ORANGE CA
92868-2862
US

V. Phone/Fax

Practice location:
  • Phone: 951-230-2052
  • Fax:
Mailing address:
  • Phone: 951-230-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number30489
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number30489
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number30489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: