Healthcare Provider Details
I. General information
NPI: 1851501787
Provider Name (Legal Business Name): BARRY LOUIS AARONSON PSYCHOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4199 CAMPUS DR STE.550
IRVINE CA
92612-4684
US
IV. Provider business mailing address
4199 CAMPUS DR STE.550
IRVINE CA
92612-4684
US
V. Phone/Fax
- Phone: 949-760-6500
- Fax: 949-509-6599
- Phone: 949-760-6500
- Fax: 949-509-6599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TP0016X |
| Taxonomy | Prescribing (Medical) Psychologist |
| License Number | PSY 6193 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: