Provider Demographics
NPI:1821142373
Name:CREIGHTON, ROULA (MD)
Entity Type:Individual
Prefix:
First Name:ROULA
Middle Name:
Last Name:CREIGHTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4199 CAMPUS DR STE 550
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-4694
Mailing Address - Country:US
Mailing Address - Phone:949-202-7566
Mailing Address - Fax:949-437-3428
Practice Address - Street 1:4199 CAMPUS DR STE 550
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-4694
Practice Address - Country:US
Practice Address - Phone:949-271-9533
Practice Address - Fax:949-437-3428
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA953762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry