SOCAL ADOLESCENT WELLNESS, INC. (NPI# 1023598299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023598299 |
| Entity Type | Organization |
| Organization Name | SOCAL ADOLESCENT WELLNESS, INC. |
| Practice Address |
16052 Beach Blvd Ste 135 Huntington Beach CA 92647-3817 |
| Mailing Address |
7641 Talbert Ave Ste 215 Huntington Beach CA 92648-8617 |
| Practice Telephone | 4022508989 |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MR. JAMES SEWELL (COOWNER) |
| Authorized Official Telephone | 4022408989 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOCAL ADOLESCENT WELLNESS, LLC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| Street Address |
16052 BEACH BLVD STE 135 |
| City | HUNTINGTON BEACH |
| State | CA |
| Zip Code | 92647-3817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770926057 | Stacy Ravnikar | Speech-Language Pathologist | 16052 Beach Blvd Ste 135, Huntington Beach, CA 92647-3817 | 2013-04-16 |
| 1326697004 | Deanna Tavakoly | Marriage & Family Therapist | 16052 Beach Blvd Ste 135, Huntington Beach, CA 92647-3817 | 2019-09-05 |
| 1235575135 | Elizabeth Nideffer | Speech-Language Pathologist | 16052 Beach Blvd Ste 135, Huntington Beach, CA 92647-3817 | 2013-05-17 |
| 1730523903 | Ricki Drabek | Speech-Language Pathologist | 16052 Beach Blvd Ste 135, Huntington Beach, CA 92647-3817 | 2013-04-18 |
| 1477996742 | Dana Flack | Specialist/Technologist | 16052 Beach Blvd Ste 135, Huntington Beach, CA 92647-3817 | 2013-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417464231 | Patricia Michelle Ramsey | Counselor | 16761 Viewpoint Lane, Apt 386, Huntington Beach, CA 92647 | 2018-01-02 |
| 1780103390 | Luz Flores | Health Educator | 8041 Newman Avenue, Hungtington Beach, CA 92647 | 2017-09-14 |
| 1134649106 | Louise Polzel | Social Worker | 17111 Beach Blvd St 205, Huntington Beach, CA 92647 | 2017-06-21 |
| 1205364015 | Chi Hong Nguyen | Family Medicine | 8201 Newman Ave 101, Huntington, CA 92647 | 2017-05-24 |
| 1396281770 | Sandra Vera | Specialist/Technologist | 7812 Edinger Ave. #400, Huntington Beach, CA 92647 | 2017-01-10 |
| 1245773050 | Sherika Benjamin | Technician, Pathology | 8211 San Angelo Drive Suit #f2, Huntington Beach, CA 92647 | 2016-11-28 |
| 1306389440 | Nhi Pham Nguyen | Behavioral Analyst | 17732 Beach Blvd., Suite G, Huntington Beach, CA 92647 | 2016-11-21 |
| 1710345095 | Pacific Beach Medical Group, Inc. | Internal Medicine | 16111 Beach Blvd., Huntington Beach, CA 92647 | 2016-02-02 |
| 1699148494 | Daniel Bui | Dentist | 16900-a Goldenwest St, Huntington Beach, CA 92647 | 2015-11-03 |
| 1598132359 | Hayley Patricia Buchanan | Specialist/Technologist | 23441 S. Pointe Drive, Suite 245, Laguna Hills, ORANGE COUNTY 92647 | 2015-08-27 |
| Find all providers in zip 92647 | ||||
| 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 |
|---|---|---|---|---|
| 1417373226 | Waymakers | Clinic/Center | 7291 Talbert Ave, Huntington Beach, CA 92648 | 2014-03-17 |
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| 1821607771 | Tonya Octave, Lcsw, Prof Corp | Clinic/Center | 237 S Lakeview Ave Ste A, Placentia, CA 92870-6756 | 2020-07-27 |
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| 1083231781 | Treehouse Child Therapy Professional Corporation | Clinic/Center | 514 N California Ave Ste 13, Beaumont, CA 92223-2120 | 2020-06-29 |
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| 1447876123 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 454 E Cerritos St, Rialto, CA 92376-3658 | 2020-06-18 |
| 1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
| 1386267870 | Bni Treatment Centers | Clinic/Center | 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 | 2020-05-19 |
| 1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
| Find all providers with the same taxonomy | ||||
| City | HUNTINGTON BEACH |
| Zip Code | 92647 |
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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.