SOCAL CENTER FOR CHANGE NPI 1104183292

NPI Information

  • NPI: 1104183292
  • Provider Name: SOCAL CENTER FOR CHANGE
  • Classification: Psychologist - 103TP0016X
  • Specialization: Prescribing (Medical)
  • Entity Type: Organization
  • Address: 1110 E CHAPMAN AVE
    SUITE 204
    ORANGE, CA
    ZIP 92866
  • Phone: (714) 453-0688

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NPI Details

SOCAL CENTER FOR CHANGE is a prescribing (medical) psychologist in Orange, CA. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. SOCAL CENTER FOR CHANGE NPI is 1104183292. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1110 E CHAPMAN AVE
SUITE 204
ORANGE, CA
ZIP 92866-139
Phone: (714) 453-0688
Fax: (714) 453-0691

The provider's authorized official is Geoffrey Phillips .
The authorized official title is President and has the following contact phone number (714) 453-0688.

The enumeration date for this NPI number is 4/13/2012 and was last updated on 4/13/2012.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TP0016XPsychologistPrescribing (Medical)Yes

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: 3/30/2025

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