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General NPI Number Information
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NPI Number | 1306621990
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Entity Type | Organization
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Legal Business Name | MCCORMICK PSYCHOLOGY GROUP
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 18003 SKY PARK CIR STE H2
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City | IRVINE
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State | CA
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Zip | 92614-6526
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Country | US
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Telephone | 949-464-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 18003 SKY PARK CIR STE H2
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City | IRVINE
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State | CA
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Zip | 92614-6526
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Country | US
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Telephone | 949-464-8272
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO CLINICAL PSYCHOLOGIST
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Name | DR. TARA MCCORMICK
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Credential | PSYD
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Telephone | 949-228-7143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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