Provider Demographics
NPI:1558523738
Name:MANSUR, RUMANA (PHD)
Entity type:Individual
Prefix:DR
First Name:RUMANA
Middle Name:
Last Name:MANSUR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MACARTHUR BLVD STE 600
Mailing Address - Street 2:EAST TOWER
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2517
Mailing Address - Country:US
Mailing Address - Phone:657-223-3360
Mailing Address - Fax:
Practice Address - Street 1:4000 MACARTHUR BLVD STE 600
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2517
Practice Address - Country:US
Practice Address - Phone:657-223-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27348103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist