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WELL STREET PSYCHOLOGICAL INC. NPI 1760936835


NPI Information

NPI: 1760936835
Provider Name: WELL STREET PSYCHOLOGICAL INC.
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
100 S IMPERIAL HWY
ANAHEIM, CA
ZIP 92807
Phone: (714) 730-9355
Get Directions

WELL STREET PSYCHOLOGICAL INC. is a clinical psychologist in Anaheim, CA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. WELL STREET PSYCHOLOGICAL INC. NPI is 1760936835. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 S IMPERIAL HWY
ANAHEIM, CA
ZIP 92807-943
Phone: (714) 730-9355
Fax: (714) 730-9355

The provider's authorized official is Martin J Eaton .
The authorized official title is Ceo/owner and has the following contact phone number (714) 730-9355.

The enumeration date for this NPI number is 8/6/2016 and was last updated on 8/6/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TB0200XPsychologistCognitive & BehavioralPSY15533CALIFORNIANo
2103TC1900XPsychologistCounselingPSY15533CALIFORNIANo
3103TC2200XPsychologistClinical Child & AdolescentPSY15533CALIFORNIANo
4103TC0700XPsychologistClinicalPSY15533CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PSY15533OTHERCALIFORNIAPSYCHOLOGIST LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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