Organization
SOUTH COUNTY PSYCHOLOGICAL, INC.
Active
Other names
Susan J. Novak, PhD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN JOY NOVAK PHD (PRESIDENT/CLINICAL PSYCHOLOGIST)
(949) 297-6680
Entity
Organization
Contact information
Practice address
23832 ROCKFIELD BLVD STE 130, LAKE FOREST, CA 92630-2860
(949) 297-6680
(949) 861-6321
Mailing address
23832 ROCKFIELD BLVD STE 130, LAKE FOREST, CA 92630-2860
(949) 297-6680
(949) 861-6321
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY22415
CA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
PSY22415
CA
Other
Enumeration date
12/06/2012
Last updated
03/03/2020
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