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Organization

DR HAYGOUSH KALINIAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HAYGOUSH KALINIAN PHD (NEUROPSYCHOLOGIT)
(949) 481-8414
Entity
Organization

Contact information

Practice address
30320 RANCHO VIEJO RD, ST 5, SAN JUAN CAPISTRANO, CA 92675-1581
(949) 481-8414
(949) 481-8415
Mailing address
30320 RANCHO VIEJO RD, ST 5, SAN JUAN CAPISTRANO, CA 92675-1581
(949) 481-8414
(949) 481-8415

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY20155
CA
103TC0700X
Clinical Psychologist
PSY20155
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7099933
AETNA
CA
01
CP20155
MEDICARE ID
CA
Enumeration date
04/23/2014
Last updated
04/23/2014
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