Provider Demographics
NPI:1366891145
Name:ORANGE COUNTY EDUCATIONAL PSYCHOLOGISTS
Entity type:Organization
Organization Name:ORANGE COUNTY EDUCATIONAL PSYCHOLOGISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-288-0330
Mailing Address - Street 1:28062 CALLE SAN REMO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-3307
Mailing Address - Country:US
Mailing Address - Phone:949-981-7933
Mailing Address - Fax:
Practice Address - Street 1:28062 CALLE SAN REMO
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3307
Practice Address - Country:US
Practice Address - Phone:949-981-7933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3418251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health