Healthcare Provider Details

I. General information

NPI: 1740671411
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHOLOGICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 02/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 OLD RANCH PKWY SUITE 300
SEAL BEACH CA
90740-2765
US

IV. Provider business mailing address

3020 OLD RANCH PKWY SUITE 300
SEAL BEACH CA
90740-2765
US

V. Phone/Fax

Practice location:
  • Phone: 562-799-5559
  • Fax: 562-296-6379
Mailing address:
  • Phone: 562-799-5559
  • Fax: 562-296-6379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPSY 22500
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPSY 22500
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY 22500
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 22500
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY 22500
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY 22500
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY 22500
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY 22500
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY 22500
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY 22500
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPSY 22500
License Number StateCA
# 12
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 22500
License Number StateCA

VIII. Authorized Official

Name: DR. MARILYN STRADA
Title or Position: DIRECTOR
Credential: PHD QME
Phone: 562-799-5559