Organization
REGENTS OF UNIVERSITY OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM L WIGAL PH.D. (CLINICAL PROFESSOR)
(949) 824-1812
Entity
Organization
Contact information
Practice address
19722 MACARTHUR BLVD, UCI-CHILD DEVELOPMENT CENTER, IRVINE, CA 92612-2404
(949) 824-1800
(949) 824-1811
Mailing address
19722 MACARTHUR BLVD, UCI-CHILD DEVELOPMENT CENTER, IRVINE, CA 92612-2404
(949) 824-1800
(949) 824-1811
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY14209
CA
Other
Enumeration date
10/30/2007
Last updated
11/07/2007
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