SOCAL BEHAVIORAL MEDICINE (NPI# 1134691124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134691124 |
| Entity Type | Organization |
| Organization Name | SOCAL BEHAVIORAL MEDICINE |
| Other Organization Name | SOCAL BEHAVIORAL MEDICINE |
| Practice Address |
10931 Cherry St Ste 201 Los Alamitos CA 90720-2496 |
| Mailing Address |
10650 Reagan St Unit 824 Los Alamitos CA 90720-8844 |
| Practice Telephone | 3106985252 |
| Enumeration Date | 2019-01-01 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | GINGER HULST (CO-OWNER) |
| Authorized Official Telephone | 3106985252 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SoCal Behavioral Medicine | Doing Business As Name - Organization |
| Street Address |
10931 CHERRY ST STE 201 |
| City | LOS ALAMITOS |
| State | CA |
| Zip Code | 90720-2496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871152132 | Connie Lee Wax | Social Worker | 5182 Katella, Suite 206, Los Alamitos, CA 90720 | 2019-06-11 |
| 1750891446 | Angela Lynn Hudson | Nurse Practitioner | 4281 Katella Ave Ste 215, Los Alamitos, CA 90720 | 2017-10-06 |
| 1922524149 | Tigom LLC | Pharmacy | 4434 Cerritos Ave, Los Alamitos, CA 90720 | 2017-08-18 |
| 1821531401 | Added Access Cardiology Inc | Internal Medicine | 3801 Katella Ave Suite 401, Los Alamitos, CA 90720 | 2016-11-30 |
| 1619348091 | Debbie Chen | Marriage & Family Therapist | 5182 Katella Ave Ste 202, Los Alamitos, CA 90720 | 2015-10-12 |
| 1801292974 | Michelle R. Ancharoff | Psychologist | 4281 Katella Ave #122, Los Alamitos, CA 90720 | 2014-11-17 |
| 1497179253 | Jeffrey J Mccullough | Dentist | 4281 Katella Ave Ste 112, Los Alamitos, CA 90720 | 2014-02-13 |
| 1043634124 | Alamitos Oral Surgery | Dentist | 4582 Katella Avenue, Los Alamitos, CA 90720 | 2014-02-11 |
| 1972939718 | Twin Town Corporation | Clinic/Center | 4376 Katella Ave., Los Alamitos, CA 90720 | 2013-09-25 |
| 1952644197 | Lindsay Enebak Mossinger | Internal Medicine | 3851 Katella Ave Ste 220, Los Alamitos, CA 90720 | 2013-04-05 |
| Find all providers in zip 90720 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902458540 | Medicus Telehealth Inc. | Internal Medicine | 180 N Rexford Dr, Beverly Hills, CA 90210-5406 | 2019-07-13 |
| 1962978114 | Samer Moghaddam Md, Apc | Internal Medicine | 902 N Grand Ave Ste 201, Santa Ana, CA 92701-4218 | 2018-10-15 |
| 1972009785 | William Supplee | Internal Medicine | 151 Calderon Ave Apt 96, Mountain View, CA 94041-1433 | 2018-04-02 |
| 1245767516 | Chemical Dependency Treatment Associates, Inc | Internal Medicine | 455 University Ave Ste 320, Sacramento, CA 95825-6580 | 2017-05-17 |
| 1568917367 | Mjc Hospitalist Group, Inc. | Internal Medicine | 4615 Lemona Ave, Sherman Oaks, CA 91403-2428 | 2016-08-22 |
| 1073962171 | Faried Banimahd Md Inc | Internal Medicine | 1533 E 4th St Ste 4, Santa Ana, CA 92701-5115 | 2016-06-09 |
| 1467827683 | 360 Recovery Inc | Internal Medicine | 23986 Aliso Creek Rd Ste 226, Laguna Niguel, CA 92677-3908 | 2015-12-14 |
| 1841665254 | Kpg California, LLC | Internal Medicine | 9000 W Sunset Blvd Ste 1500, West Hollywood, CA 90069-5815 | 2015-12-10 |
| 1780050278 | Craig V. Smith, M.d., A Professional Medical Corporation | Internal Medicine | 6711 Melrose Ave., Los Angeles, CA 90038 | 2015-08-19 |
| 1730561861 | Synergy Lifestyle Center, Inc. | Internal Medicine | 7910 Downing Ave Ste 200, Bakersfield, CA 93308-5016 | 2015-06-25 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMITOS |
| Zip Code | 90720 |
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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.