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General NPI Number Information
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NPI Number | 1699395012
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Entity Type | Organization
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Legal Business Name | ORANGE COUNTY NEUROPSYCHOLOGY, INC.
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Dates
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Enumeration Date | 04/26/2020
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Last Update Date | 04/26/2020
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Provider Practice Location Address
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Address Line | 27201 PUERTA REAL STE 300
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City | MISSION VIEJO
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State | CA
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Zip | 92691-8590
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Country | US
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Telephone | 949-500-9639
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Fax |
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Provider Business Mailing Address
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Address Line | 27201 PUERTA REAL STE 300
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City | MISSION VIEJO
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State | CA
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Zip | 92691-8590
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Country | US
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Telephone | 949-500-9639
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Fax |
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Authorized Official
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Title or Position | CEO, ORANGE COUNTY NEUROPSYCHOLOGY
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Name | DR. KATHLEEN MONTEMAGNI
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Credential | PHD
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Telephone | 949-500-9639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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