Provider Demographics
NPI:1477817559
Name:CENTER FOR SOCIAL COGNITION
Entity Type:Organization
Organization Name:CENTER FOR SOCIAL COGNITION
Other - Org Name:MEDIATED LEARNING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POIRIER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:949-788-9299
Mailing Address - Street 1:16 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2355
Mailing Address - Country:US
Mailing Address - Phone:949-788-9299
Mailing Address - Fax:949-453-8118
Practice Address - Street 1:16 TECHNOLOGY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2355
Practice Address - Country:US
Practice Address - Phone:949-788-9299
Practice Address - Fax:949-453-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-6782103K00000X
CAMFC28039106H00000X
CAOT 12699225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty