# SO CAL PSYCHOLOGY SERVICES APC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598277469
- **Authorized official:** MYRNA FERNANDEZ LPT (OFFICE MANAGER)
- **Authorized official phone:** (949) 542-3874

## Contact information

- **Practice address:** 34249 CAMINO CAPISTRANO STE 101, CAPO BEACH, CA 92624-1138
- **Practice address phone:** (949) 542-3874
- **Practice address fax:** (949) 484-7021
- **Mailing address:** 34249 CAMINO CAPISTRANO STE 101, CAPO BEACH, CA 92624-1138
- **Mailing address phone:** (949) 542-3874
- **Mailing address fax:** (949) 484-7021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | Yes |
| 103TC0700X | Clinical Psychologist | — | — | Yes |
| 103TF0000X | Family Psychologist | — | NULL | — |
| 103TF0000X | Family Psychologist | — | — | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/31/2017
- **Last updated:** 10/31/2017