Provider Demographics
NPI:1285888321
Name:CATHEARINE JENKINS HALL PSYCHOLOGY PHD PC
Entity type:Organization
Organization Name:CATHEARINE JENKINS HALL PSYCHOLOGY PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHEARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-367-1335
Mailing Address - Street 1:27281 LAS RAMBLAS
Mailing Address - Street 2:STE. 130
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6324
Mailing Address - Country:US
Mailing Address - Phone:949-367-1335
Mailing Address - Fax:949-305-3380
Practice Address - Street 1:27281 LAS RAMBLAS
Practice Address - Street 2:STE. 130
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6324
Practice Address - Country:US
Practice Address - Phone:949-367-1335
Practice Address - Fax:949-305-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8239103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP8239Medicare UPIN