Provider Demographics
NPI:1780899831
Name:TERI M. POKRAJAC, PSY.D. & ASSOCIATES
Entity type:Organization
Organization Name:TERI M. POKRAJAC, PSY.D. & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:M
Authorized Official - Last Name:POKRAJAC
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-475-0145
Mailing Address - Street 1:4060 CAMPUS DR
Mailing Address - Street 2:STE. 120
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2217
Mailing Address - Country:US
Mailing Address - Phone:949-475-0145
Mailing Address - Fax:949-475-2977
Practice Address - Street 1:4060 CAMPUS DR
Practice Address - Street 2:STE. 120
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2217
Practice Address - Country:US
Practice Address - Phone:949-475-0145
Practice Address - Fax:949-475-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15458103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty