Trauma Therapy Ca Psychology Corporation

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

TRAUMA THERAPY CA PSYCHOLOGY CORPORATION

Practice address

19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407

Phone

(949) 943-1877

Fax

(949) 508-1856

NPI assigned

Oct 5, 2020

Last updated

Oct 5, 2020By 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

Dr. Debora Jason, PHDNPI 1912388505

Title

Clinical Director

Phone

(949) 943-1877

Specialties & licenses 3

Addresses

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.

• Debora Sara Jason, PHD

  • Psychologist
  • Orange, CA
  • NPI 1912388505
  NPD Authorized official

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1205433083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 HARRINGAY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180882",
            "telephone_number": "949-943-1877",
            "fax_number": "949-508-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19712 MACARTHUR BLVD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122407",
            "telephone_number": "949-943-1877",
            "fax_number": "949-508-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA THERAPY CA PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "JASON",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "949-943-1877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 5, 2020; 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.