Basic Information
Provider Information
NPI: 1285885376
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNOLD
FirstName: MARGERY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1666 N MAIN ST
Address2: SUITE 400
City: SANTA ANA
State: CA
PostalCode: 927017417
CountryCode: US
TelephoneNumber: 7147045900
FaxNumber:  
Practice Location
Address1: 1666 N MAIN ST
Address2: SUITE 400
City: SANTA ANA
State: CA
PostalCode: 927017417
CountryCode: US
TelephoneNumber: 7147045900
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/07/2008
LastUpdateDate: 11/16/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X  Y Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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