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Contact Information

DEPTH PSYCHOTHERAPY CENTER A PROFESSIONAL PSYCHOLOGICAL CORPORA
4199 CAMPUS DR.
SUITE 550
IRVINE, CA92612
 Phone: 949-422-4488
 Fax: 949-640-2255
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DEPTH PSYCHOTHERAPY CENTER A PROFESSIONAL PSYCHOLOGICAL CORPORA

NPI # 1154638450
LBN Legal business name DEPTH PSYCHOTHERAPY CENTER A PROFESSIONAL PSYCHOLOGICAL CORPORA
Authorized official SHERRI MAHDAVI - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/08/2010
Last updated 07/01/2020 - About 6 years ago
Identifiers
CA License # PSY21506
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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