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SOUTHERN CALIFORNIA PSYCHOLOGICAL
NPI 1053745497
Specialist in Tustin, CA

Active since August 21, 2013
17821 17TH ST STE 250, TUSTIN, CA 92780(714) 505-2093(714) 573-0072 Get Directions Write a Review

NPPES record last updated: August 21, 2013. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Southern California Psychological NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN CALIFORNIA PSYCHOLOGICAL (NPI 1053745497) is a healthcare organization registered as a specialist in Tustin, California and active in the NPI registry since August 2013. The organization lists Kimberely Tilley, President, as its authorized official.

NPPES Registry Identity

NPI1053745497
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHERN CALIFORNIA PSYCHOLOGICAL
Location Address17821 17TH ST STE 250Tustin, CA 92780-2173
Mailing Address17821 17th St Ste 250Tustin, CA 92780-2173 · (714) 505-2093 · Fax (714) 573-0072
Phone(714) 505-2093
Fax(714) 573-0072
Organization SubpartNo
Authorized OfficialKimberely TilleyPresident · (714) 505-2093
Enumeration DateAugust 21, 2013
✔ NPI 1053745497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · PSY23488
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
17821 17TH ST STE 250, Tustin, CA 92780
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FIG GARDEN MEDICAL GROUP
Specialist
17821 17TH ST STE 250
TUSTIN, CA 92780
Orange County (714) 505-2093
EXAM SPECIALIST MEDICAL GROUP
Specialist
17821 17TH ST STE 250
TUSTIN, CA 92780
Orange County (714) 505-2093

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern California Psychological's NPI number?

The NPI number for Southern California Psychological is 1053745497. It was assigned to this organization in the NPPES registry on August 21, 2013.

Where is Southern California Psychological located?

Southern California Psychological is located at 17821 17th St Ste 250, Tustin, CA 92780. The listed phone number is (714) 505-2093.

What is Southern California Psychological's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southern California Psychological was last updated on August 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.