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General NPI Number Information
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NPI Number | 1336679109
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Entity Type | Organization
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Legal Business Name | UCR HEALTH - PSYCHIATRY
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 18881 VON KARMAN AVE # 1227
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City | IRVINE
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State | CA
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Zip | 92612-1500
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Country | US
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Telephone | 844-827-8000
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Fax | 951-263-7238
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Provider Business Mailing Address
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Address Line | PO BOX 741696
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City | LOS ANGELES
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State | CA
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Zip | 90074-1696
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Country | US
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Telephone | 518-277-7939
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, PHYSICIAN RELATIONS
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Name | ERIN FERENCIK
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Credential |
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Telephone | 951-827-7793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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