TRAUMA THERAPY CA PSYCHOLOGY CORPORATION (NPI# 1205433083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205433083 |
| Entity Type | Organization |
| Organization Name | TRAUMA THERAPY CA PSYCHOLOGY CORPORATION |
| Practice Address |
19712 Macarthur Blvd Ste 110 Irvine CA 92612-2407 |
| Mailing Address |
258 Harringay Irvine CA 92618-0882 |
| Practice Telephone | 9499431877 |
| Practice Fax Number | 9495081856 |
| Mailing Telephone | 9499431877 |
| Mailing Fax Number | 9495081856 |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | DR. DEBORA JASON (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 9499431877 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
19712 MACARTHUR BLVD STE 110 |
| City | IRVINE |
| State | CA |
| Zip Code | 92612-2407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538448345 | Connie Joo Won | Psychologist | 19712 Macarthur Blvd Ste 110, Irvine, CA 92612-2407 | 2011-08-10 |
| 1669083150 | Sara Cameron | Marriage & Family Therapist | 19712 Macarthur Blvd Ste 110, Irvine, CA 92612-2407 | 2020-08-10 |
| 1770960999 | Jennifer Kim | Marriage & Family Therapist | 19712 Macarthur Blvd Ste 110, Irvine, CA 92612-2407 | 2015-04-27 |
| 1801290945 | Robyn Tamanaha | Marriage & Family Therapist | 19712 Macarthur Blvd Ste 110, Irvine, CA 92612-2407 | 2014-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615984 | Sara Afsharpour | Marriage & Family Therapist | 2001 Business Center Dr, # 150, Irvine, CA 92612 | 2019-12-05 |
| 1952959207 | Dorothy Dawn Malsack | Dietitian, Registered | 20 Pergola, Irvine, CA 92612 | 2019-08-29 |
| 1992350508 | Masi Hashemian Dds Inc | Dentist | Park Place Dentistry, 2981 Michelson Dr., Suite #b, Irvine, CA 92612 | 2019-08-09 |
| 1518426907 | Linklan Logistics Inc | Transportation Broker | 19200 Von Karman Ave Ste 612, Irvine, CA 92612 | 2019-03-15 |
| 1598220535 | Dorise Hebenstreit | Marriage & Family Therapist | 2151 Michelson Dr Ste 286, Irvine, CA 92612 | 2019-02-04 |
| 1871033365 | Livhome, Inc. | In Home Supportive Care | 19762 Macarhtur Blvd, Suite 120, Irvine, CA 92612 | 2017-03-02 |
| 1073061511 | Susan Nguyen | Marriage & Family Therapist | 2081 Business Center Dr Ste 109, Irvine, CA 92612 | 2016-09-13 |
| 1043617574 | Jason Polhamus | Community Health Worker | 4885 Royce Rd, Irivne, CA 92612 | 2014-11-26 |
| 1013313386 | Marisa Lepore | Marriage & Family Therapist | 19742 Centerpointe Plaza, Suite #125, Irvine, CA 92612 | 2014-11-13 |
| 1558798462 | Fatima Manesh | Acupuncturist | 8 Palmento Way, Irvine, CA 92612 | 2013-10-09 |
| Find all providers in zip 92612 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225659618 | Gauri Saxena | Psychologist | 242 Dewdrop, Irvine, CA 92603-0650 | 2020-04-27 |
| 1083198162 | Kyle Kermott | Psychologist | 18010 Sky Park Cir Ste 290, Irvine, CA 92614-6487 | 2018-09-24 |
| 1245713163 | Saimir Thano | Psychologist | 203 Student Services I, Irvine, CA 92697-0001 | 2018-09-07 |
| 1730525536 | Shirin Ansari | Psychologist | 16220 Scientific, Irvine, CA 92618-4349 | 2013-05-20 |
| 1831474345 | Elham Shoja | Psychologist | 8 Corporate Park Suite 300, Irvine, CA 92606 | 2011-10-15 |
| 1538448345 | Connie Joo Won | Psychologist | 19712 Macarthur Blvd Ste 110, Irvine, CA 92612-2407 | 2011-08-10 |
| 1366734477 | Yoon Shim Lee | Psychologist | 4605 Barranca Pkwy Ste 101d, Irvine, CA 92604-1726 | 2011-05-07 |
| 1770884470 | James Shafer Ph.d. A Psychological Corp. | Psychologist | 6 Venture Ste 350, Irvine, CA 92618-7350 | 2010-11-11 |
| 1588971741 | Erica Lehman | Psychologist | 15615 Alton Parkway, Suite 230, Irvine, CA 92618-7306 | 2010-09-09 |
| 1285834424 | Tracy A Williamson | Psychologist | 300 Spectrum Dr., Irvine, CA 92618 | 2007-07-24 |
| Find all providers in IRVINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.