Healthcare Provider Details

I. General information

NPI: 1184793671
Provider Name (Legal Business Name): NEUROPSYCHOLOGY ASSESSMENT SERVICES, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20371 IRVINE AVE STE A-160
SANTA ANA CA
92707-5651
US

IV. Provider business mailing address

20371 IRVINE AVE STE A-160
SANTA ANA CA
92707-5651
US

V. Phone/Fax

Practice location:
  • Phone: 714-540-5010
  • Fax:
Mailing address:
  • Phone: 714-540-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY15997
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY15997
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY15997
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY15997
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY15997
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY15997
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPSY15997
License Number StateCA

VIII. Authorized Official

Name: DR. GAYLE K DEUTSCH
Title or Position: OWNER-PRESIDENT
Credential: PH.D.
Phone: 949-633-8568