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General NPI Number Information
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NPI Number | 1932826542
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Entity Type | Organization
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Legal Business Name | MARCUM PSYCHOLOGICAL SERVICES CORP
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 30310 RANCHO VIEJO RD
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1576
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Country | US
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Telephone | 949-427-5183
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Fax |
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Provider Business Mailing Address
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Address Line | 2884 EL RIO CIR
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City | COSTA MESA
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State | CA
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Zip | 92626-4112
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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 | FOUNDER
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Name | MEGHAN MARCUM
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Credential | PSYD
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Telephone | 949-427-5183
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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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Taxonomy #2
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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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