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Organization
TRAUMA THERAPY CA PSYCHOLOGY CORPORATION
Active
Organization
TRAUMA THERAPY CA PSYCHOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORA JASON PHD (CLINICAL DIRECTOR)
(949) 943-1877
Entity
Organization
Contact information
Practice address
19712 MACARTHUR BLVD STE 110, IRVINE, CA 92612-2407
(949) 943-1877
(949) 508-1856
Mailing address
258 HARRINGAY, IRVINE, CA 92618-0882
(949) 943-1877
(949) 508-1856
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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