Provider Demographics
NPI:1194860973
Name:HANSINK & ASSOCIATES
Entity Type:Organization
Organization Name:HANSINK & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANSINK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-933-3556
Mailing Address - Street 1:29222 RANCHO VIEJO RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1041
Mailing Address - Country:US
Mailing Address - Phone:949-933-3556
Mailing Address - Fax:949-481-1149
Practice Address - Street 1:29222 RANCHO VIEJO RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1016
Practice Address - Country:US
Practice Address - Phone:949-933-3556
Practice Address - Fax:949-481-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16087103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA572780Medicare UPIN
CACP16087Medicare ID - Type Unspecified