Provider Demographics
NPI:1982895421
Name:PSYCHOLOGICAL ASSESSMENT SERVICES
Entity Type:Organization
Organization Name:PSYCHOLOGICAL ASSESSMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MPN COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZORILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-972-0040
Mailing Address - Street 1:PO BOX 6299
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-6200
Mailing Address - Country:US
Mailing Address - Phone:714-972-0040
Mailing Address - Fax:714-972-0477
Practice Address - Street 1:2107 N. BROADWAY #207
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706
Practice Address - Country:US
Practice Address - Phone:714-972-0040
Practice Address - Fax:714-972-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12317103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty