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General NPI Number Information
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NPI Number | 1043842974
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Entity Type | Organization
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Legal Business Name | INSIGHT PSYCHOLOGY CENTER, INC.
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Dates
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Enumeration Date | 02/08/2020
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Last Update Date | 02/08/2020
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Provider Practice Location Address
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Address Line | 1101 DOVE ST STE 190
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2827
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Country | US
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Telephone | 949-630-0630
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Fax | 949-688-5577
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Provider Business Mailing Address
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Address Line | 27 GREENMOOR
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City | IRVINE
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State | CA
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Zip | 92614-7467
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Country | US
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Telephone | 949-466-8686
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Fax | 949-688-5577
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Authorized Official
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Title or Position | CEO
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Name | DR. CAREY SHERILYN INCLEDON
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Credential | PSYD
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Telephone | 949-630-0630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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