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NPI Code Detail

MEDICARE: ERIN BETH POPP MA, LEP

MEDICARE: ERIN BETH POPP MA, LEP
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
1103TS0200XSchool Psychologist3706CA
2103TB0200XCognitive & Behavioral Psychologist3706CA

General Provider Information

NPI Number : 1588390348
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN BETH POPP MA, LEP
Provider Business Mailing Address
First Line : 31815 CAMINO CAPISTRANO STE 26
Second Line :
City : SAN JUAN CAPISTRANO
State : CA
Zip : 92675-3254
Country : US
Telephone Number : 949-422-2789
Fax Number :
Provider Business Practice Location Address
First Line : 31815 CAMINO CAPISTRANO STE 26
Second Line :
City : SAN JUAN CAPISTRANO
State : CA
Zip : 92675-3254
Country : US
Telephone Number : 949-422-2789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2022
Last Update Date : 07/25/2022

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Directions to “ ERIN BETH POPP MA, LEP” Practice Location

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