NPIMap

Organization Active NPI

Mind Opener Psychological Services, Inc

  • Counseling Psychologist
  • Mission Viejo, CA
National Provider Identifier
1508016569
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY 17982 Issued in CA
Legal business name
MIND OPENER PSYCHOLOGICAL SERVICES, INC
Practice address
27001 La Paz Rd Ste 403
Mission Viejo, CA 92691-5529
Phone
(949) 215-4200
Fax
(949) 215-5600
NPI assigned
Sep 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Authorized official

Name
Dr. Richard Allen Shulman, PH.D.
Title
President
Phone
(949) 215-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X PSY 17982 CA Primary

Addresses

Primary practice location

27001 La Paz Rd Ste 403
Mission Viejo, CA 92691-5529

Mailing address

27001 La Paz Rd Ste 403
Mission Viejo, CA 92691-5529
Phone (949) 215-4200

National Provider Directory

National Provider Directory

Locations

27001 La Paz Rd
Ste 403
Mission Viejo, CA 92691
Phone (949) 215-4200

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1508016569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27001 LA PAZ RD STE 403",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915529",
            "telephone_number": "949-215-4200",
            "fax_number": "949-215-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27001 LA PAZ RD STE 403",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915529",
            "telephone_number": "949-215-4200",
            "fax_number": "949-215-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND OPENER PSYCHOLOGICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "SHULMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-215-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY 17982",
            "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 Dec 3, 2009; 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.