Provider Demographics
NPI:1629446505
Name:PARPAL, MARY (PHD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:PARPAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17772 IRVINE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3256
Mailing Address - Country:US
Mailing Address - Phone:949-432-0505
Mailing Address - Fax:949-258-5154
Practice Address - Street 1:17772 IRVINE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3256
Practice Address - Country:US
Practice Address - Phone:949-432-0505
Practice Address - Fax:949-258-5154
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13083103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical