NPIMap

Organization Active NPI

Socal Center for Change

  • Prescribing (Medical) Psychologist
  • Orange, CA
National Provider Identifier
1104183292
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
Legal business name
SOCAL CENTER FOR CHANGE
Practice address
1110 E Chapman Ave
Suite 204
Orange, CA 92866-2139
Phone
(714) 453-0688
Fax
(714) 453-0691
NPI assigned
Apr 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Geoffrey Phillips, M.D.
Title
President
Phone
(714) 453-0688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TP0016X Primary

Addresses

Primary practice location

1110 E Chapman Ave
Suite 204
Orange, CA 92866-2139

Mailing address

1110 E Chapman Ave
Suite 204
Orange, CA 92866-2139
Phone (714) 453-0688

National Provider Directory

National Provider Directory

Locations

1110 E Chapman Ave
Ste 204
Orange, CA 92866
Phone (714) 453-0688

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1104183292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E CHAPMAN AVE",
            "address_2": "SUITE 204",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662139",
            "telephone_number": "714-453-0688",
            "fax_number": "714-453-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E CHAPMAN AVE",
            "address_2": "SUITE 204",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662139",
            "telephone_number": "714-453-0688",
            "fax_number": "714-453-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL CENTER FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-13",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-453-0688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.