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General NPI Number Information
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NPI Number | 1457159089
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Entity Type | Organization
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Legal Business Name | PAXWELL CHILD & FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 27281 LAS RAMBLAS STE 200
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City | MISSION VIEJO
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State | CA
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Zip | 92691-8303
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Country | US
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Telephone | 949-490-2819
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Fax |
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Provider Business Mailing Address
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Address Line | 17602 17TH ST STE 120-66
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City | TUSTIN
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State | CA
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Zip | 92780-1961
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ATHALIE MOUREY
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Credential |
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Telephone | 949-490-2819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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