Organization
COUNTY OF ORANGE
Active
Other names
PEI School Based Mental Health Svcs
Organization subpart
No
Provider details
NPI number
Authorized official
CHI RAJALINGAM PH.D. (CHIEF COMPLIANCE OFFICER)
(714) 834-5937
Entity
Organization
Contact information
Practice address
4000 W METROPOLITAN DR STE 402, ORANGE, CA 92868-3504
(714) 954-2900
(714) 938-2012
Mailing address
405 W 5TH ST STE 212, SANTA ANA, CA 92701-4522
(714) 568-5614
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30GQ
—
CA
Enumeration date
06/08/2020
Last updated
06/08/2020
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