OrganizationActive
Children'S Hospital of Orange County
NPI 1194118018 · Pediatric Rehabilitation Medicine Physician · Orange, CA
Provider details
- NPI number
- 1194118018
- Entity type
- Organization
- Primary specialty
- Pediatric Rehabilitation Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Children'S Hospital of Orange County
- Organization subpart
- Yes
- Authorized official
- Mark Kelly, Director, Business Services(714) 509-7964
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
- Child & Adolescent Psychiatry Physician2084P0804X
Allopathic & Osteopathic Physicians
- Clinical Child & Adolescent Psychologist103TC2200X
Behavioral Health & Social Service Providers
- Clinical Psychologist103TC0700X
Behavioral Health & Social Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
Practice location
1201 W La Veta Ave
Orange, CA 92868-4203
Phone: (714) 509-8649
Fax: (714) 509-8374
Approximate (ZIP-level) locationGet directions
Mailing address
1201 W La Veta Ave
Orange, CA 92868-4203
Other names (DBA / former)
- Doing business as
- Cs Miscellaneous Physician Services
Registry dates
- Enumerated
- 2015-03-17
- Last updated
- 2015-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.