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General NPI Number Information
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NPI Number | 1730067927
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL ASSESSMENT CENTER OF SOUTH ORANGE COUNTY
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 24800 CHRISANTA DR STE 260
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City | MISSION VIEJO
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State | CA
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Zip | 92691-4837
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Country | US
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Telephone | 949-462-9114
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Fax | 949-460-9114
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Provider Business Mailing Address
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Address Line | 14292 CULVER DR 920
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City | IRVINE
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State | CA
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Zip | 92604
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Country | US
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Telephone | 949-462-9114
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Fax | 949-460-9114
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Authorized Official
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Title or Position | BILLING SPECAILIST
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Name | ADRIENNE KENNEDY
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Credential |
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Telephone | 949-426-9114
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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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Taxonomy #2
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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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