# REGENTS OF UNIVERSITY OF CALIFORNIA

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

## Provider details

- **NPI number:** 1912186628
- **Authorized official:** TIM L WIGAL PH.D. (CLINICAL PROFESSOR)
- **Authorized official phone:** (949) 824-1812

## Contact information

- **Practice address:** 19722 MACARTHUR BLVD, UCI-CHILD DEVELOPMENT CENTER, IRVINE, CA 92612-2404
- **Practice address phone:** (949) 824-1800
- **Practice address fax:** (949) 824-1811
- **Mailing address:** 19722 MACARTHUR BLVD, UCI-CHILD DEVELOPMENT CENTER, IRVINE, CA 92612-2404
- **Mailing address phone:** (949) 824-1800
- **Mailing address fax:** (949) 824-1811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PSY14209 | CA | Yes |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 11/07/2007