Active NPI
Sean Brian Harris, PSYD
- Clinical Child & Adolescent Psychologist
- Mission Viejo, CA
National Provider Identifier
1346616554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PSY34875
- Practice address
- 23120 Alicia Pkwy Ste 237
Mission Viejo, CA 92692-1210 - Phone
- (949) 229-5790
- NPI assigned
- Aug 12, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY34875 | CA | Primary |
Addresses
Primary practice location
23120 Alicia Pkwy Ste 237
Mission Viejo, CA 92692-1210
Mailing address
130 S B St
Tustin, CA 92780-3609
Phone (888) 265-9114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY34875 | CA | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Alternatives Inc. | Past | Accepting new patients | |
| Western Youth Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Case Management Agency
- Fountain Valley, CA
- NPI 1174989735
-
- Community/Behavioral Health Agency
- Fountain Valley, CA
- NPI 1215484019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1346616554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 S B ST",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803609",
"telephone_number": "888-265-9114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23120 ALICIA PKWY STE 237",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926921210",
"telephone_number": "949-229-5790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "SEAN",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-12",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY34875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.