| NPI | 1659980290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTEN DEVEREUX Administrator 949-200-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 1041C0700X Social Worker, Clinical | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2026-08-11 |