Healthcare Provider Details

I. General information

NPI: 1851138135
Provider Name (Legal Business Name): DOCTHERA PSYCHOLOGICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MACARTHUR BLVD SUITE 600
NEWPORT BEACH CA
92660-2517
US

IV. Provider business mailing address

4000 MACARTHUR BLVD STE 600
NEWPORT BEACH CA
92660-2517
US

V. Phone/Fax

Practice location:
  • Phone: 714-224-0830
  • Fax:
Mailing address:
  • Phone: 714-224-0830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SONIA SINGH
Title or Position: PSYCHOLOGIST
Credential: PSYD, CCATP, CMHIMP
Phone: 714-224-0830