1538727318 NPI number — WEL-MOR PSYCHOLOGICAL GROUP, INC.

Table of content: ELLEN M. GRIFFIN PSYD (NPI 1427257260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538727318 NPI number — WEL-MOR PSYCHOLOGICAL GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEL-MOR PSYCHOLOGICAL GROUP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538727318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4019 WESTERLY PL STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660-2333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-540-9070
Provider Business Mailing Address Fax Number:
714-884-4347

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5130 E LA PALMA AVE STE 212
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92807-2078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-540-9070
Provider Business Practice Location Address Fax Number:
714-884-4347
Provider Enumeration Date:
06/05/2019

Additional Information

Authorized Official

Authorized Official Last Name:
WELCH
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
714-540-9070

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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