Southern California Psychiatric Associates

Primary specialty

PsychologistTaxonomy code 103T00000X

License

27276 Issued in CA

Legal business name

SOUTHERN CALIFORNIA PSYCHIATRIC ASSOCIATES

Practice address

14351 Red Hill Ave Ste C
Tustin, CA 92780-6271

Phone

(949) 489-5564

Fax

(949) 493-9350

NPI assigned

Jul 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Richard Granese, M.D.

Title

Medical Director/Psychiatrist

Phone

(949) 489-5564

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1306220199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14351 RED HILL AVE STE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806271",
            "telephone_number": "949-489-5564",
            "fax_number": "949-493-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14351 RED HILL AVE STE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806271",
            "telephone_number": "949-489-5564",
            "fax_number": "949-493-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "GRANESE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PSYCHIATRIST",
        "authorized_official_telephone_number": "949-489-5564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "27276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Maxine Sosna, M.D.
• Adriana Soto Mondragon-Hill, LMFT
• Kimberly Soto
• South Coast Dermatology Institute, a Medical Corporation
• Southern California Acute Care Physicians
• Southern California Psychological
• Alyson Spain
• Specialized Physical Therapy, Apc
• Speech Language Pathology
• Suzette Marie Spence, MFT

• Psychologist in Tustin, CA
• Providers in Tustin, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.