Provider Demographics
NPI:1174069439
Name:OSCAR H. OO, PSY.D. A PROFESSIONAL PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:OSCAR H. OO, PSY.D. A PROFESSIONAL PSYCHOLOGICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:OO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-648-3704
Mailing Address - Street 1:4000 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 600, EAST TOWER
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2558
Mailing Address - Country:US
Mailing Address - Phone:949-648-3704
Mailing Address - Fax:714-352-6471
Practice Address - Street 1:4000 MACARTHUR BLVD
Practice Address - Street 2:SUITE 600, EAST TOWER
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2558
Practice Address - Country:US
Practice Address - Phone:949-648-3704
Practice Address - Fax:714-352-6471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22699103TB0200X
CAPSY 22699103TC0700X, 103TC2200X
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty