Carlson, Carol Victor
Carlson, Carol Victor is an sole proprietor health care provider with primary practice located at 4199 Campus Dr Ste 550 , Irvine CA 92612-4694. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Carlson, Carol Victor can be contacted via phone (510) 444-1110.Contact Information
Primary practice address
4199 Campus Dr Ste 550
Irvine CA 92612-4694
Phone: (510) 444-1110
Fax: (949) 885-8885
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY14518 | California |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY14518 | California |
Profile Details
| NPI number | 1710102595 |
|---|---|
| LBN Legal business name | Carlson, Carol Victor |
| Credentials | DOCTORATE - PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 16th, 2007 |
| Last updated | Jun 5th, 2024 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710102595 | NPPES |
| California | Other | 0PL145180 | BLUE SHIELD PROVIDER # |
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