Physician Compare National (NPI:1821178997)

HEALTHCARE PROVIDER: JUDY RENEE MAHONEY PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1821178997
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557451945
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071221000561
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MAHONEY
	Individual professional last name
Provider First Name	JUDY
	Individual professional first name
Provider Middle Name	RENEE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4199 CAMPUS DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 550
	Group Practice or individual's line 2 address
City	IRVINE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	926124694
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y