| Judy Mahoney, Ph.d., A Professional Psychology Corporation | |
|
4199 Campus Dr Suite 550 Irvine CA 92612-4684 | |
| (949) 903-4110 | |
| Not Available |
| Full Name | Judy Mahoney, Ph.d., A Professional Psychology Corporation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4199 Campus Dr, Irvine, California |
| Authorized Official Name and Position | Judy Renee Mahoney (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9499034110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Judy Mahoney, Ph.d., A Professional Psychology Corporation 4199 Campus Dr Suite 550 Irvine CA 92612-4684 Ph: (949) 903-4110 | Judy Mahoney, Ph.d., A Professional Psychology Corporation 4199 Campus Dr Suite 550 Irvine CA 92612-4684 Ph: (949) 903-4110 |
| NPI Number | 1851573562 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 05/12/2016 |
| Medicare PECOS PAC ID | 2466542857 |
|---|---|
| Medicare Enrollment ID | O20071221000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851573562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY16479 (California) | Primary |
| Provider Name | Judy R Mahoney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821178997 PECOS PAC ID: 1557451945 Enrollment ID: I20071221000561 |
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