WELL STREET PSYCHOLOGICAL INC. (NPI# 1760936835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760936835 |
| Entity Type | Organization |
| Organization Name | WELL STREET PSYCHOLOGICAL INC. |
| Practice Address |
100 S Imperial Hwy Anaheim CA 92807-3943 |
| Practice Telephone | 7147309355 |
| Practice Fax Number | 7147309355 |
| Mailing Telephone | 7147309355 |
| Mailing Fax Number | 7147309355 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-06 |
| Authorized Official Name | DR. MARTIN J EATON (CEO/OWNER) |
| Authorized Official Telephone | 7147309355 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY15533 | CA | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
PSY15533 | CA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY15533 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY15533 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PSYCHOLOGIST LICENSE | PSY15533 | 01 |
| Street Address |
100 S IMPERIAL HWY |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92807-3943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400759 | Katie Greasby | Marriage & Family Therapist | 509 S. Villa Real Dr. #117, Anaheim Hills, CA 92807 | 2020-09-08 |
| 1386201481 | Joseph Hasrouni | Counselor | Cvs 9753, 5735 E. La Palma Ave, Anaheim, CA 92807 | 2019-05-23 |
| 1144739277 | Luis Antonio Perez | Social Worker | 2112 E 4th St. #107, Santa Ana, CA 92807 | 2017-09-20 |
| 1548781883 | F.foroutan Dds Inc. | Dentist | 5031 E. Orangethorpe Ave., Suite # B-2, Anaheim Hills, CA 92807 | 2017-06-27 |
| 1487101515 | Eloy Ramirez | Counselor | 233 S. Quintana Drive, Anaheim, CA 92807 | 2016-09-07 |
| 1255786448 | K's Loving Care | Custodial Care Facility | 1211 N Amelia St, Anaheim, CA 92807 | 2016-04-26 |
| 1265806673 | Jessica Vickers | Marriage & Family Therapist | 5500 E Santa Ana Canyon Rd Ste 216, Anaheim, CA 92807 | 2015-11-23 |
| 1033596796 | Donovan Garcia Teves | Specialist | 1261 Lakeview Ave., Suite 'a', Anaheim Hills, CA 92807 | 2015-05-01 |
| 1235544354 | Nicole Reaves | Occupational Therapist | 5630 E Santa Ana Canyon Rd Ste 105, Anaheim, CA 92807 | 2014-06-26 |
| 1093143471 | Behrang E Toubak | Counselor | 6381 E Via Arboles, Anaheim, CA 92807 | 2013-10-23 |
| Find all providers in zip 92807 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689187007 | Douangratdy Psychological Services, P.C. | Psychologist | 8275 E Blackwillow Cir Apt 206, Anaheim, CA 92808-2914 | 2017-11-07 |
| 1174907810 | Anaheim Hills Psychological Services | Psychologist | 155 N Riverview Dr, Ste. 209, Anaheim, CA 92808-1225 | 2015-07-13 |
| 1639450935 | Deborah A Berberich | Psychologist | 1210 N. Jefferson Street, Unit F, Anaheim, CO 92807 | 2011-08-31 |
| 1558506139 | Edward F Tennen | Psychologist | 201 E Center St Ste 112 Pmb 5075, Anaheim, CA 92805-7212 | 2008-12-10 |
| 1942406368 | Elena Margarita Abalo-dehmer | Psychologist | 2411 W La Palma Ave, 401, Anaheim, CA 92801-2639 | 2007-06-22 |
| 1053513960 | Janira Jacoubs-beye | Psychologist | 5100 E La Palma Ave, Ste.104, Anaheim, CA 92807-2081 | 2007-06-03 |
| 1578606240 | Sung Hye Yi | Psychologist | 1020 S Anaheim Blvd Ste 300, Anaheim, CA 92805-5854 | 2007-02-14 |
| 1457342933 | Margaret Ann Atkinson | Psychologist | 520 N Brookhurst St, Ste 135, Anaheim, CA 92801-5235 | 2005-11-02 |
| 1558845495 | Christine Jones | Psychologist | 1661 N Raymond Ave Ste 214, Anaheim, CA 92801-1167 | 2018-09-17 |
| 1669827176 | Alexis Avila | Psychologist | 2400 E Katella Ave, Suite 800, Anaheim, CA 92806-5945 | 2016-05-03 |
| Find all providers in ANAHEIM | ||||
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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.