Individual
DR. GINNY LIWANPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1101 DOVE ST, #155, NEWPORT BEACH, CA 92660-2839
(949) 491-6135
(714) 362-8783
Mailing address
1101 DOVE ST, #155, NEWPORT BEACH, CA 92660-2839
(949) 491-6135
(714) 362-8783
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 20910
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY 20910
CA
103TF0000X
Family Psychologist
PSY 20910
CA
Other
Enumeration date
01/26/2010
Last updated
01/21/2015
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