| NPI | 1922744101 | 
|---|---|
| Former Legal Business Name | PORTER PSYCHOLOGICAL, APC | 
| Entity Type | Organization | 
| Authorized Contact | JENNIFER DERGREGORIAN CEO 714-328-6307  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical | 
| Enumeration Date | 2022-05-10 | 
| Last Update Date | 2023-11-06 |