Healthcare Provider Details

I. General information

NPI: 1386588226
Provider Name (Legal Business Name): MM NEUROPSYCH A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20422 BEACH BLVD STE 230
HUNTINGTON BEACH CA
92648-4398
US

IV. Provider business mailing address

20422 BEACH BLVD STE 230
HUNTINGTON BEACH CA
92648-4398
US

V. Phone/Fax

Practice location:
  • Phone: 949-385-0348
  • Fax:
Mailing address:
  • Phone: 949-385-0348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN MAGUIRE
Title or Position: CEO
Credential: PSYD
Phone: 949-385-0348