Healthcare Provider Details

I. General information

NPI: 1477254175
Provider Name (Legal Business Name): EMILY MOUSER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 E 4TH ST
SANTA ANA CA
92701
US

IV. Provider business mailing address

14820 INGLEWOOD AVE
LAWNDALE CA
90260-1229
US

V. Phone/Fax

Practice location:
  • Phone: 714-525-8509
  • Fax:
Mailing address:
  • Phone: 310-780-9373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: