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Organization
TAKOS PSYCHOLOGY, PC
Active
Organization
TAKOS PSYCHOLOGY, PC
Active
Other names
South Coast Psychological Services
Organization subpart
No
Provider details
NPI number
Authorized official
DIMITRA TAKOS PSYD (LICENSED CLINICAL PSYCHOLOGIST)
(949) 701-7976
Entity
Organization
Contact information
Practice address
901 DOVE ST STE 150, NEWPORT BEACH, CA 92660-3018
(949) 701-7976
Mailing address
901 DOVE ST STE 150, NEWPORT BEACH, CA 92660-3018
(949) 701-7976
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21903
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982841953
—
CA
Enumeration date
06/20/2017
Last updated
07/21/2022
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