| Doctor Name: | DR. MARIA M. PETROSINO |
| NPI Number: | 1124093554 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY13776 |
| Business Practice Address: | 30101 Town Center Dr Suite 201 Laguna Niguel, CA - 926775006 |
| Business Phone Number: | 9493650309 |
| Business Fax Number: | 9498312439 |
| Mailing Address: | Po Box 6546, LAGUNA NIGUEL |
| State: | CA |
| Postal Code: | 926076546 |
| Phone Number: | 9493650309 |
| Fax Number: | 9498312439 |
| NPI Enumeration Date: | 02/20/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY13776 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |