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NPI Code Detail

MEDICARE: CLARITY CALIFORNIA PSYCHOLOGICAL SERVICES, INC

MEDICARE: CLARITY CALIFORNIA PSYCHOLOGICAL SERVICES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11558662445OTHERNPI

General Provider Information

NPI Number : 1316570005
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARITY CALIFORNIA PSYCHOLOGICAL SERVICES, INC
Provider Business Mailing Address
First Line : 2 PISTORIA LN
Second Line :
City : LADERA RANCH
State : CA
Zip : 92694-1508
Country : US
Telephone Number : 949-617-0252
Fax Number :
Provider Business Practice Location Address
First Line : 27281 LAS RAMBLAS STE 200
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-8303
Country : US
Telephone Number : 949-617-0252
Fax Number :
Authorized Official
Title or Position : OWNER
Name : COLLEEN LONG
Credential :
Telephone Number : 949-617-0252
Provider Enumeration Date : 02/20/2020
Last Update Date : 02/10/2023

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