CHANGING TIDES TREATMENT LLC (NPI# 1053701425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053701425 |
| Entity Type | Organization |
| Organization Name | CHANGING TIDES TREATMENT LLC |
| Practice Address |
2021 Sperry Ave Suite 3 Ventura CA 93003-7408 |
| Mailing Address |
5301 Seabreeze Way Oxnard CA 93035-1048 |
| Practice Telephone | 8448833869 |
| Mailing Telephone | 8448833869 |
| Mailing Fax Number | 8056245311 |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |
| Authorized Official Name | BERKELEY BEAUDEAN DAINS (CEO) |
| Authorized Official Telephone | 8055061541 |
| Authorized Official Credential | CATC, CIP,BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
2021 SPERRY AVE SUITE 3 |
| City | VENTURA |
| State | CA |
| Zip Code | 93003-7408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831195387 | Judith Alexandre | Psychologist | 2021 Sperry Ave, Ste 9, Ventura, CA 93003-7418 | 2005-06-21 |
| 1649754961 | Luciane De Greef | Marriage & Family Therapist | 2021 Sperry Ave, Ventura, CA 93003-7408 | 2018-09-21 |
| 1629504717 | Thomas Echlin | Marriage & Family Therapist | 2021 Sperry Ave, Suite 41, Ventura, CA 93003-7408 | 2017-05-10 |
| 1316496763 | Joseph P Clark | Marriage & Family Therapist | 2021 Sperry Ave, # 41, Ventura, CA 93003-7408 | 2016-09-27 |
| 1508315250 | Chaning Tides Treatment | Family Medicine | 2021 Sperry Ave, Suite 18, Ventura, CA 93003-7408 | 2016-09-22 |
| 1184002636 | Jill Schwartz | Marriage & Family Therapist | 2021 Sperry Ave, Suite 22, Ventura, CA 93003-7408 | 2015-05-15 |
| 1962894402 | Richard Casillas | Marriage & Family Therapist | 2021 Sperry Ave, Suite 22, Ventura, CA 93003-7408 | 2015-02-20 |
| 1295131753 | Charletta Erb | Marriage & Family Therapist | 2021 Sperry Ave, Suite 41, Ventura, CA 93003-7408 | 2014-11-11 |
| 1548673445 | Matthew Bryant | Acupuncturist | 2021 Sperry Ave, Suite 22, Ventura, CA 93003-7408 | 2014-06-09 |
| 1962657767 | Melinda Meeks | Counselor | 2021 Sperry Ave, Ventura, CA 93003-7408 | 2008-11-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645924 | Community Memorial Health System | Pharmacy | 2790 Loma Vista Road, Ventura, CA 93003 | 2020-06-29 |
| 1730702952 | Sarah Manon Begert | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave., Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-21 |
| 1033763677 | Ashley Danielle Aguilar | Counselor | 5740 Ralston Suite 100, Ventura, CA 93003 | 2019-08-01 |
| 1730747239 | Azadeh Ellsworth | Nurse Practitioner | 1752 S Victoria Ave Ste 250, Ventura, CA 93003 | 2019-05-31 |
| 1992275556 | Melissa Marie Cole | Social Worker | 4949 Market St, Ventura, CA 93003 | 2018-11-27 |
| 1851868400 | Weldon Acupuncture Professional Corporation | Acupuncturist | 3737 Telegraph Road, Suite F, Ventura, CA 93003 | 2018-10-31 |
| 1952876468 | Isabella Florencia Gallegos | Specialist/Technologist | 1857 Knoll Dr., Ventura, CA 93003 | 2018-10-11 |
| 1437645421 | Jill Huang Wong | Psychologist | 3585 Maple St Ste 248, Ventura, CA 93003 | 2018-07-02 |
| 1346735156 | Lisa Ngoc Thi Nguyen | Student in an Organized Health Care Education/Training Program | 147 N. Brent Street, Ventura, CA 93003 | 2018-06-25 |
| 1457845331 | Khloe Frank | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Suite 201, Ventura, CA 93003 | 2018-06-14 |
| Find all providers in zip 93003 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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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.