Regents Of University Of California | |
19262 Jamboree Rd Irvine CA 92612-2502 | |
(949) 824-2343 | |
(949) 824-8737 |
Full Name | Regents Of University Of California |
---|---|
Speciality | Psychologist - Clinical Child & Adolescent |
Location | 19262 Jamboree Rd, Irvine, California |
Authorized Official Name and Position | Ronald A Kotkin (CLINICAL PROFESSOR) |
Authorized Official Contact | 9498246292 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Regents Of University Of California 19262 Jamboree Rd Irvine CA 92612-2502 Ph: (949) 824-2343 | Regents Of University Of California 19262 Jamboree Rd Irvine CA 92612-2502 Ph: (949) 824-2343 |
NPI Number | 1003001009 |
---|---|
Provider Enumeration Date | 09/12/2007 |
Last Update Date | 09/14/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003001009 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC2200X | Psychologist - Clinical Child & Adolescent | PSY12351 (California) | Primary |
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