Advanced Behavioral Care, Inc. a Psychological Corporation

Key facts

NPI

1306941596

Entity type

Organization (NPI type 2)

Primary specialty

Psychologist 103T00000X

License

PSY12071 (CA)

Legal business name

ADVANCED BEHAVIORAL CARE, INC. A PSYCHOLOGICAL CORPORATION

Practice address

27001 La Paz Rd
Suite 418
Mission Viejo, CA 92691-5502

Phone

(949) 215-2500

Fax

(949) 203-8686

NPI assigned

Sep 13, 2006

Organization subpart

No

Authorized official

Name

Dr. Stuart Kirschbaum, PH.D. NPI 1073557476

Title

President

Phone

(949) 215-2500

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

• Stuart Kirschbaum, PH.D. Clinical Psychologist · Mission Viejo, CA · NPI 1073557476
  NPD (past) Authorized official
• Deborah Lynn Kirschbaum, PH.D. Clinical Psychologist · Mission Viejo, CA · NPI 1497873731
  NPD (past)

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 28, 2011.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1306941596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27001 LA PAZ RD",
            "address_2": "SUITE 418",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915502",
            "telephone_number": "949-215-2500",
            "fax_number": "949-203-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27001 LA PAZ RD",
            "address_2": "SUITE 418",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915502",
            "telephone_number": "949-215-2500",
            "fax_number": "949-203-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED BEHAVIORAL CARE, INC. A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "KIRSCHBAUM",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-215-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12070",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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