Provider Demographics
NPI:1952318586
Name:PSYCHOLOGICAL ADVANCES IN COPING EDUCATION INC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL ADVANCES IN COPING EDUCATION INC
Other - Org Name:PACE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-608-2227
Mailing Address - Street 1:PO BOX 6599
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92616
Mailing Address - Country:US
Mailing Address - Phone:310-608-2227
Mailing Address - Fax:310-632-7227
Practice Address - Street 1:23792 ROCKFIELD BLVD
Practice Address - Street 2:SUITE 290
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630
Practice Address - Country:US
Practice Address - Phone:949-458-1073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16440Medicare ID - Type Unspecified