Provider Demographics
NPI:1831404557
Name:RESSEL, MEGAN LOUISE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LOUISE
Last Name:RESSEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17821 17TH ST
Mailing Address - Street 2:STE 260
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2136
Mailing Address - Country:US
Mailing Address - Phone:562-967-1797
Mailing Address - Fax:
Practice Address - Street 1:17821 17TH ST
Practice Address - Street 2:STE 260
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2136
Practice Address - Country:US
Practice Address - Phone:562-967-1797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health