Provider Demographics
NPI:1609675420
Name:SERENE SHIFT PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:SERENE SHIFT PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:LAUREEN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-423-9426
Mailing Address - Street 1:2707 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5405
Mailing Address - Country:US
Mailing Address - Phone:949-423-9426
Mailing Address - Fax:
Practice Address - Street 1:2707 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5405
Practice Address - Country:US
Practice Address - Phone:949-423-9426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty