Provider Demographics
NPI:1326057274
Name:HALL, JAMES PHILMORE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILMORE
Last Name:HALL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:PHIL
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2209 E VISTA MESA WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1737
Mailing Address - Country:US
Mailing Address - Phone:714-527-7886
Mailing Address - Fax:714-282-9503
Practice Address - Street 1:5816 CORPORATE AVE STE 170
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-4736
Practice Address - Country:US
Practice Address - Phone:714-527-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11440103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP11440AMedicare PIN