SOCAL ADOLESCENT WELLNESS, INC. (NPI# 1083230262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083230262 |
Entity Type | Organization |
Organization Name | SOCAL ADOLESCENT WELLNESS, INC. |
Practice Address |
23072 Lake Center Dr Ste 214 Lake Forest CA 92630-2899 |
Mailing Address |
16052 Beach Blvd Ste 135 Huntington Beach CA 92647-3817 |
Practice Telephone | 9494674324 |
Mailing Telephone | 9494674324 |
Enumeration Date | 2020-06-23 |
Last Update Date | 2020-06-23 |
Authorized Official Name | REBECCA M HARRIS (CFO) |
Authorized Official Telephone | 9494674324 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023598299 | Socal Adolescent Wellness, Inc. | Clinic/Center | 16052 Beach Blvd Ste 135, Huntington Beach, CA 92647-3817 | 2018-08-17 |
Street Address |
23072 LAKE CENTER DR STE 214 |
City | LAKE FOREST |
State | CA |
Zip Code | 92630-2899 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
Find all providers in zip 92630 |
Taxonomy Code | 261QM0855X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adolescent and Children Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508333477 | Orange County Revive Services, Inc. | Clinic/Center | 24432 Muirlands Blvd Ste 221, Lake Forest, CA 92630-3951 | 2018-10-30 |
1346585908 | South County Psychological, Inc. | Clinic/Center | 23832 Rockfield Blvd Ste 130, Lake Forest, CA 92630-2860 | 2012-12-06 |
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1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
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1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
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Find all providers with the same taxonomy |
City | LAKE FOREST |
Zip Code | 92630 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.