Provider Demographics
NPI:1780836809
Name:MICHAEL H FOUST, PH.D.
Entity Type:Organization
Organization Name:MICHAEL H FOUST, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:FOUST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:714-834-9222
Mailing Address - Street 1:2201 N GRAND AVE UNIT 10433
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92711-9998
Mailing Address - Country:US
Mailing Address - Phone:714-834-9222
Mailing Address - Fax:
Practice Address - Street 1:2201 N. GRAND AVE
Practice Address - Street 2:UNIT #10433
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92711
Practice Address - Country:US
Practice Address - Phone:714-834-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6432103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP6432OtherMEDICARE