Provider Demographics
NPI:1023349305
Name:ORANGE COUNTY CENTER FOR PSYCHOTHERAPY AND COUNSELING
Entity type:Organization
Organization Name:ORANGE COUNTY CENTER FOR PSYCHOTHERAPY AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHITCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:714-447-8011
Mailing Address - Street 1:213 N POMONA AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1926
Mailing Address - Country:US
Mailing Address - Phone:714-447-8011
Mailing Address - Fax:714-871-2203
Practice Address - Street 1:213 N POMONA AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1926
Practice Address - Country:US
Practice Address - Phone:714-447-8011
Practice Address - Fax:714-871-2203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10754261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health