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General NPI Number Information
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NPI Number | 1396756383
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Entity Type | Individual
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Provider Name | LORAINE L. WALSH PH.D
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 26932 OSO PARKWAY #200
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City | MISSION VIEJO
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State | CA
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Zip | 92691
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Country | US
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Telephone | 949-367-9797
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Fax | 949-348-9626
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Provider Business Mailing Address
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Address Line | 26932 OSO PARKWAY #200
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City | MISSION VIEJO
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State | CA
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Zip | 92691
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Country | US
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Telephone | 949-367-9797
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Fax | 949-348-9626
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PSY4408
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY4408
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License Number State | CA
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