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NPI Code Detail

MEDICARE: PERSPECTIVE PSYCHOLOGICAL SERVICES INC

MEDICARE: PERSPECTIVE 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
1103TC2200XClinical Child & Adolescent Psychologist
2103TM1800XIntellectual & Developmental Disabilities Psychologist
3251S00000XCommunity/Behavioral Health Agency
4103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1467922492
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERSPECTIVE PSYCHOLOGICAL SERVICES INC
Provider Business Mailing Address
First Line : 24901 HON AVE
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-4317
Country : US
Telephone Number : 949-280-4554
Fax Number :
Provider Business Practice Location Address
First Line : 1 SANSOME ST STE 3500
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94104-4436
Country : US
Telephone Number : 949-280-4554
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. MONA REDJA
Credential : PSYD
Telephone Number : 949-280-4554
Provider Enumeration Date : 12/03/2018
Last Update Date : 07/14/2020

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Directions to “PERSPECTIVE PSYCHOLOGICAL SERVICES INC ” Practice Location

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