Healthcare Provider Details

I. General information

NPI: 1053904771
Provider Name (Legal Business Name): UPLYFT PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2021
Last Update Date: 02/13/2021
Certification Date: 02/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 BUSINESS CENTER DR
IRVINE CA
92612-1001
US

IV. Provider business mailing address

2102 BUSINESS CENTER DR
IRVINE CA
92612-1001
US

V. Phone/Fax

Practice location:
  • Phone: 714-716-9045
  • Fax: 760-859-3877
Mailing address:
  • Phone: 714-716-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: EIMA MESGARHA
Title or Position: OWNER, PROVIDER
Credential: PSYD
Phone: 714-716-9045