Fenton, Michael

Fenton, Michael is an sole proprietor health care provider with primary practice located at 1000 Quail St Suite 170, Newport Beach CA 92660-2839. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fenton, Michael can be contacted via phone (949) 833-7933.

Contact Information

Primary practice address
1000 Quail St Suite 170 Newport Beach CA 92660-2839
Phone: (949) 833-7933
Fax: (949) 833-3963
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY9254 California

Profile Details

NPI number 1881654846
LBN Legal business name Fenton, Michael
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2006
Last updated Sep 11th, 2008 - about 16 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881654846 NPPES
California MEDICAID PSY092540

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