Provider Demographics
NPI:1083445944
Name:INSTITUTE OF PEDIATRIC PSYCHOLOGY
Entity type:Organization
Organization Name:INSTITUTE OF PEDIATRIC PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HARPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-244-2014
Mailing Address - Street 1:145 W MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 W MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7751
Practice Address - Country:US
Practice Address - Phone:949-244-2014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty