Healthcare Provider Details

I. General information

NPI: 1497499537
Provider Name (Legal Business Name): THE OCD TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18430 BROOKHURST ST STE 202A
FOUNTAIN VALLEY CA
92708-6758
US

IV. Provider business mailing address

18430 BROOKHURST ST STE 202A
FOUNTAIN VALLEY CA
92708-6758
US

V. Phone/Fax

Practice location:
  • Phone: 714-253-4537
  • Fax:
Mailing address:
  • Phone: 714-253-4537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BRADLEY THOMAS WILSON
Title or Position: OWNER
Credential: LMFT
Phone: 714-253-4537