Provider Demographics
NPI:1346879277
Name:CALIFORNIA EVALUATION AND PSYCHOTHERAPY CENTER, INC.
Entity Type:Organization
Organization Name:CALIFORNIA EVALUATION AND PSYCHOTHERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:LEGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:714-900-3907
Mailing Address - Street 1:135 E HOLLY ST APT 304
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3942
Mailing Address - Country:US
Mailing Address - Phone:714-980-2332
Mailing Address - Fax:
Practice Address - Street 1:1370 BREA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4128
Practice Address - Country:US
Practice Address - Phone:714-900-3907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health