Avant Garde Psychology Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

AVANT GARDE PSYCHOLOGY INC

Practice address

2737 E Coast Hwy Ste F
Corona del Mar, CA 92625-2110

Phone

(949) 412-7178

NPI assigned

Oct 12, 2020

Organization subpart

No

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

Authorized official

Name

Dr. George Valere Estonactoc, PH.D.NPI 1306263785

Title

Clinical Psychologist

Phone

(949) 412-7178

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.

• George Valera Estonactoc, PH.D.

  • Clinical Psychologist
  • Laguna Niguel, CA
  • NPI 1306263785
  NPD Authorized official

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1376141440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28292 EL SUR",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774422",
            "telephone_number": "949-412-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 E COAST HWY STE F",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252110",
            "telephone_number": "949-412-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANT GARDE PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-11",
        "status": "A",
        "authorized_official_last_name": "ESTONACTOC",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "VALERE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "949-412-7178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Corona del Mar, CA
• Providers in Corona del Mar, 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 12, 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.