BODY MIND SPIRIT IOP INC (NPI# 1255733853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255733853 |
| Entity Type | Organization |
| Organization Name | BODY MIND SPIRIT IOP INC |
| Practice Address |
665 Camino De Los Mares Ste 104 San Clemente CA 92673 |
| Mailing Address |
665 Camino De Los Mares Ste 104 San Clemente CA 92673-2840 |
| Practice Telephone | 9492487377 |
| Practice Fax Number | 8668052796 |
| Mailing Telephone | 9492487377 |
| Mailing Fax Number | 8668052796 |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2018-08-24 |
| Authorized Official Name | WILLIAM MARTIN (CEO) |
| Authorized Official Telephone | 9492477377 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY9840 | CA | Behavioral Health & Social Service Providers |
| Street Address |
665 CAMINO DE LOS MARES STE 104 |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| 1750611026 | Kristen Penrose Weitz | Speech-Language Pathologist | 970 Calle Amanecer, Suite A, San Clemente, CA 92673 | 2010-01-07 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699003376 | William Frederick Gordon | Psychologist | 1211 Puerta Del Sol, San Clemente, CA 92673 | 2009-11-18 |
| 1568604288 | Pamela N Skorstad | Psychologist | 647 Camino De Los Mares Ste 226, San Clemente, CA 92673-2860 | 2009-03-26 |
| 1922631928 | Matthew Ryan Chester | Psychologist | 101 W Avenida Vista Hermosa Ste 120, San Clemente, CA 92672-7707 | 2020-02-18 |
| 1831615467 | Lily Randall | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673-2832 | 2017-08-15 |
| 1063887016 | Howard Medical Corp | Psychologist | 101 W Avenida Vista Hermosa Ste 122, San Clemente, CA 92672-7707 | 2015-12-02 |
| 1396955258 | Jennifer Lafferty O'connor | Psychologist | 616 S El Camino Real, Suite G16, San Clemente, CA 92672-4298 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306690 | Eileen Kay Laughman | Psychologist | 24545 Town Center Dr Apt 5406, Valencia, CA 91355-1397 | 2020-11-08 |
| 1194324954 | Rachel Charman | Psychologist | 1001 Dove St Ste 110, Newport Beach, CA 92660-2845 | 2020-10-22 |
| 1700485760 | Melissa Ernestine Munoz | Psychologist | 353 H St # 1517, Chula Vista, CA 91910-5501 | 2020-10-21 |
| 1235737669 | Maha Nasrallah-babenko | Psychologist | 33442 Valley View Ct, Dana Point, CA 92629-1515 | 2020-10-16 |
| 1689272544 | Kaleidoscope Solutions Family Therapy | Psychologist | 25876 The Old Road, #85, Stevenson Ranch, CA 91381 | 2020-10-13 |
| 1992302814 | Sheena Gill | Psychologist | 2501 E Chapman Ave Ste 265, Fullerton, CA 92831-3108 | 2020-10-04 |
| 1255948600 | Kesha Patrice | Psychologist | 939 Ellis St, San Francisco, CA 94109-7714 | 2020-09-29 |
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1376159541 | Jill Caryn Campbell | Psychologist | 342 Ocho Rios Way, Oak Park, CA 91377-5541 | 2020-09-22 |
| 1225644487 | Brock Louis Pistel | Psychologist | 939 Ellis St Fl 67, San Francisco, CA 94109-7714 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
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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.