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Organization

CHILD AND ADOLESCENT BEHAVIORAL HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IRIS A RICHARDSON PH.D. (PARTNER)
(714) 696-1385
Entity
Organization

Contact information

Practice address
17772 IRVINE BLVD STE 103, TUSTIN, CA 92780
(714) 696-1385
(888) 972-4028
Mailing address
17772 IRVINE BLVD, STE 103, TUSTIN, CA 92780-3256
(714) 696-1385
(888) 972-4028

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
103TF0000X
Family Psychologist
103TH0100X
Health Service Psychologist

Other

Enumeration date
07/27/2017
Last updated
09/10/2024
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