Healthcare Provider Details

I. General information

NPI: 1447182472
Provider Name (Legal Business Name): VARIATIONS PSYCHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 HYLAND AVE STE 205
COSTA MESA CA
92626-1403
US

IV. Provider business mailing address

1048 IRVINE AVE # 717
NEWPORT BEACH CA
92660-4602
US

V. Phone/Fax

Practice location:
  • Phone: 949-873-4617
  • Fax: 949-209-4544
Mailing address:
  • Phone: 949-873-4617
  • Fax: 949-209-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTA M. SHINN
Title or Position: CEO, LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 949-424-5707