Provider Demographics
NPI:1326331315
Name:UNITED CEREBRAL PALSY OF ORANGE COUNTY
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF ORANGE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-333-6437
Mailing Address - Street 1:980 ROOSEVELT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3672
Mailing Address - Country:US
Mailing Address - Phone:949-333-6413
Mailing Address - Fax:949-333-6441
Practice Address - Street 1:980 ROOSEVELT
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3672
Practice Address - Country:US
Practice Address - Phone:949-333-6413
Practice Address - Fax:949-333-6441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED CEREBRAL PALSY OF ORANGE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-24
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP17144252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency