Provider Demographics
NPI:1659408060
Name:TRUE, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:TRUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1731
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92781-1731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18001 SKY PARK CIR
Practice Address - Street 2:BLDG. 50, #C
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6511
Practice Address - Country:US
Practice Address - Phone:714-404-7090
Practice Address - Fax:562-684-4141
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42710106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist