Healthcare Provider Details

I. General information

NPI: 1821142373
Provider Name (Legal Business Name): ROULA CREIGHTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19200 VON KARMAN AVE STE 350
IRVINE CA
92612-8509
US

IV. Provider business mailing address

19200 VON KARMAN AVE STE 350
IRVINE CA
92612-8509
US

V. Phone/Fax

Practice location:
  • Phone: 949-202-7566
  • Fax: 949-437-3428
Mailing address:
  • Phone: 949-202-7566
  • Fax: 949-437-3428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA95376
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: