Provider Demographics
NPI:1992859474
Name:MAY, PAULA S (PH D)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:MAY
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:S
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PH D
Mailing Address - Street 1:242 W MAIN ST
Mailing Address - Street 2:STE 200B
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7716
Mailing Address - Country:US
Mailing Address - Phone:714-469-6684
Mailing Address - Fax:657-212-5189
Practice Address - Street 1:242 W MAIN ST
Practice Address - Street 2:STE 200B
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7716
Practice Address - Country:US
Practice Address - Phone:949-600-5231
Practice Address - Fax:714-665-2228
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP15137Medicare ID - Type Unspecified