Basic Information
Provider Information
NPI: 1275624595
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEMPSEY
FirstName: JAMES
MiddleName: A
NamePrefix: MR.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 275 N WAVERLY ST
Address2:  
City: ORANGE
State: CA
PostalCode: 928661732
CountryCode: US
TelephoneNumber: 7145176353
FaxNumber: 7145176306
Practice Location
Address1: 405 W 5TH ST
Address2:  
City: SANTA ANA
State: CA
PostalCode: 927014519
CountryCode: US
TelephoneNumber: 7148344707
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/28/2006
LastUpdateDate: 12/19/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLCS19701CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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