Provider Demographics
NPI:1003385949
Name:OCCS OC COUNSELING SERVICES
Entity Type:Organization
Organization Name:OCCS OC COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:949-424-3543
Mailing Address - Street 1:11078 EMERSON WAY
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-2820
Mailing Address - Country:US
Mailing Address - Phone:949-424-3543
Mailing Address - Fax:
Practice Address - Street 1:12821 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2711
Practice Address - Country:US
Practice Address - Phone:949-424-3543
Practice Address - Fax:714-665-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2019-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCSW6531OtherCA BOARD OF BEHAVIORAL HEALTH SCIENCE