Individual
DR. BENJAMIN WILLIAM STRACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
23 CORPORATE PLAZA DR STE 150, NEWPORT BEACH, CA 92660-7908
(949) 629-2560
Mailing address
2668 S GRAND AVE, SANTA ANA, CA 92705-5402
(949) 722-7805
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY 24425
CA
103TB0200X
Cognitive & Behavioral Psychologist
PSY 24425
CA
103TC0700X
Clinical Psychologist
Primary
PSY 24425
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY 24425
CA
103TE1100X
Exercise & Sports Psychologist
PSY 24425
—
103TF0000X
Family Psychologist
PSY 24425
CA
103TH0004X
Health Psychologist
PSY 24425
CA
Other
Enumeration date
09/22/2011
Last updated
12/14/2018
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