Provider Demographics
NPI:1730067927
Name:BEHAVIORAL ASSESSMENT CENTER OF SOUTH ORANGE COUNTY
Entity type:Organization
Organization Name:BEHAVIORAL ASSESSMENT CENTER OF SOUTH ORANGE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECAILIST
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-426-9114
Mailing Address - Street 1:14292 CULVER DR
Mailing Address - Street 2:920
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604
Mailing Address - Country:US
Mailing Address - Phone:949-462-9114
Mailing Address - Fax:949-460-9114
Practice Address - Street 1:24800 CHRISANTA DR STE 260
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4837
Practice Address - Country:US
Practice Address - Phone:949-462-9114
Practice Address - Fax:949-460-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty