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General NPI Number Information
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NPI Number | 1679271779
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Entity Type | Organization
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Legal Business Name | COR PSYCHOLOGICAL SERVICES CORPORATION
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 23832 ROCKFIELD BLVD STE 120
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City | LAKE FOREST
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State | CA
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Zip | 92630-2870
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Country | US
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Telephone | 949-423-3824
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Fax |
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Provider Business Mailing Address
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Address Line | 23832 ROCKFIELD BLVD STE 120
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City | LAKE FOREST
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State | CA
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Zip | 92630-2870
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Country | US
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Telephone | 949-423-3824
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAIMIR THANO
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Credential | PH.D.
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Telephone | 949-423-3824
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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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