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General NPI Number Information
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NPI Number | 1962984013
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Entity Type | Organization
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Legal Business Name | POINTER PSYCHOTHERAPY, INC
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 17662 IRVINE BLVD STE 7
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City | TUSTIN
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State | CA
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Zip | 92780-3132
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Country | US
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Telephone | 949-439-7558
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Fax |
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Provider Business Mailing Address
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Address Line | 9402 PIER DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7207
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Country | US
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Telephone | 949-439-7558
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARA POINTER
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Credential | PSYD
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Telephone | 949-439-7558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY26036
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License Number State | CA
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