Provider Demographics
NPI:1124184163
Name:ROSS ASSOCIATES, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:ROSS ASSOCIATES, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-852-1410
Mailing Address - Street 1:7 CORPORATE PARK
Mailing Address - Street 2:SUITE 235
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-5107
Mailing Address - Country:US
Mailing Address - Phone:949-852-1410
Mailing Address - Fax:949-852-0220
Practice Address - Street 1:7 CORPORATE PARK
Practice Address - Street 2:SUITE 235
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5107
Practice Address - Country:US
Practice Address - Phone:949-852-1410
Practice Address - Fax:949-852-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8592103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16625Medicare ID - Type Unspecified