LORI BOTHAM (NPI# 1912450925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912450925 |
| Entity Type | Individual |
| Full Name | LORI BOTHAM |
| Practice Address |
1700 W Cerritos Ave Unit 102 Anaheim CA 92804-6176 |
| Practice Telephone | 7149924770 |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
1700 W CERRITOS AVE UNIT 102 |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92804-6176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811517261 | Crown Care Hospice Inc | Hospice Care, Community Based | 10568 Magnolia Ave., Suite106, Stanton, CA 92804 | 2020-04-24 |
| 1154971646 | Leita Pawline Lawrene | Technician | 900 S Beach Blvd # 132, Anaheim, CA 92804 | 2019-09-17 |
| 1942767611 | Yasmen Abuyousef | Behavior Technician | 714 W Commonweath Ave, Suite C, Fullerton, CA 92804 | 2019-02-28 |
| 1225501224 | Brandon Pourazima | Physician Assistant | 631 S Brookhurst St Ste 213b, Anaheim, CA 92804 | 2019-01-02 |
| 1043782576 | Origins Home Health Care Inc. | Home Health | 137 1/2 S So Knott, Anaheim, CA 92804 | 2018-12-21 |
| 1346762150 | Inhee Shinn | Acupuncturist | 1717 W. Ball Road., Anaheim, CA 92804 | 2017-07-13 |
| 1689122459 | Jayanthi Ravikumar Md Inc | Physical Medicine & Rehabilitation | 3356 W Ball Road, #216, Anaheim, CA 92804 | 2016-09-21 |
| 1215307954 | Tuan Manh Hoang | Dentist | 1317 S. Courtright Street, Anaheim, CA 92804 | 2015-10-06 |
| 1598101602 | Optimal Sleep Center | Clinical Medical Laboratory | 3340 West Ball Road Suite B, Anaheim, CA 92804 | 2013-05-15 |
| 1376885673 | Michelle Lananh Dang | Pharmacist | 1913 W. Elm Pl, Anaheim, CA 92804 | 2013-03-25 |
| Find all providers in zip 92804 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063041895 | Jose Luis Marron I | Counselor | 617 S Harbor Blvd Unit B, Anaheim, CA 92805-4527 | 2020-04-03 |
| 1811524838 | Travis Clay Reysen | Counselor | 2966 E Frontera St Apt 89, Anaheim, CA 92806-3430 | 2020-03-27 |
| 1356981393 | Options | Counselor | 617 S Harbor Blvd Ste B, Anaheim, CA 92805-4527 | 2020-01-07 |
| 1225680994 | Michael Cross | Counselor | 710 N. Anaheim Blvd Anaheim, Ca 92805, 710 N.anaheim Blvd, Anaheim, CA 92805 | 2019-07-12 |
| 1386201481 | Joseph Hasrouni | Counselor | Cvs 9753, 5735 E. La Palma Ave, Anaheim, CA 92807 | 2019-05-23 |
| 1619477262 | Robert Daniel Colbert | Counselor | 532 N Magnolia Ave # 278, Anaheim, CA 92801-4937 | 2018-02-20 |
| 1336668607 | Lorretta Cruz Hernandez | Counselor | 2071 S Jetty Dr Apt 3, Anaheim, CA 92802-4465 | 2017-09-18 |
| 1437679784 | Margaret Elena Popp | Counselor | Adult and Older Adult Behavioral Health Services, 2035 E. Ball Rd, Anaheim, CA 92806 | 2017-06-27 |
| 1700336732 | Jerry Ibarra | Counselor | 9331 Pacific Ave, Anaheim, CA 92804-6374 | 2016-10-13 |
| 1336501477 | Jon Heller | Counselor | 1005 S Mountvale Ct, Anaheim, CA 92808-2108 | 2016-03-28 |
| Find all providers in ANAHEIM | ||||
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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.