INGRAHAM TREVOR - NPI: 1770125577


Mood disorder is a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature. The classification is known as mood (affective) disorders in International Classification of Diseases (ICD).

NPI: 1770125577
Entity Type: Person: individual human being who furnishes health care.
Provider First Name: TREVOR
Provider Last Name: INGRAHAM
Provider Gender Code: M
Provider Enumeration Date: 10/13/2019
Last Update Date: 10/13/2019

Business Address:

Provider First Line Business Mailing Address: 2575 YORBA LINDA BLVD
Provider Business Mailing Address City Name: FULLERTON
Provider Business Mailing Address State Name: CA
Provider Business Mailing Address Postal Code: 92831
Provider Business Mailing Address Country Code (If outside U.S.): US

Mailing Address:

Provider First Line Business Practice Location Address: 2575 YORBA LINDA BLVD
Provider Business Practice Location Address City Name: FULLERTON
Provider Business Practice Location Address State Name: CA
Provider Business Practice Location Address Postal Code: 92831
Provider Business Practice Location Address Country Code (If outside U.S.): US
Phone: 7144497400

Primary Taxonomy:

Taxonomy Code: 363A00000X
License Number:
License State:
Healthcare Provider Primary Taxonomy Switch: Y - The taxonomy is the primary taxonomy (there can be only one per NPI record
Type: Physician Assistants & Advanced Practice Nursing Providers
Classification: Physician Assistant
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant
Taxonomy Description: is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine
Source: The National Provider Identifier

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