Illuminate Psychological Services, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ILLUMINATE PSYCHOLOGICAL SERVICES, PC

Practice address

2082 Michelson Dr Ste 215-216
Irvine, CA 92612-1212

Phone

(562) 787-9911

NPI assigned

May 14, 2021

Last updated

May 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra LabeebNPI 1235556739

Title

Partner

Phone

(949) 373-3640

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra Labeeb

  • Psychologist
  • Los Angeles, CA
  • NPI 1235556739

  Cognitive & Behavioral

  NPD Authorized official

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1144894114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2082 MICHELSON DR STE 215-216",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121212",
            "telephone_number": "562-787-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2082 MICHELSON DR STE 215-216",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121212",
            "telephone_number": "562-787-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "LABEEB",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "949-373-3640"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Irvine, CA
• Providers in Irvine, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.