SOCAL CENTER FOR CHANGE (NPI# 1104183292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104183292 |
| Entity Type | Organization |
| Organization Name | SOCAL CENTER FOR CHANGE |
| Practice Address |
1110 E Chapman Ave Suite 204 Orange CA 92866-2139 |
| Practice Telephone | 7144530688 |
| Practice Fax Number | 7144530691 |
| Mailing Telephone | 7144530688 |
| Mailing Fax Number | 7144530691 |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |
| Authorized Official Name | DR. GEOFFREY PHILLIPS (PRESIDENT) |
| Authorized Official Telephone | 7144530688 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
Behavioral Health & Social Service Providers |
| Street Address |
1110 E CHAPMAN AVE SUITE 204 |
| City | ORANGE |
| State | CA |
| Zip Code | 92866-2139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376586933 | Yun Suk Chong | Psychiatry & Neurology | 1110 E Chapman Ave, Suite 203, Orange, CA 92866-2139 | 2006-06-13 |
| 1245600097 | Katelyn Henka | Speech-Language Pathologist | 1110 E Chapman Ave, Suite 203, Orange, CA 92866-2139 | 2015-10-05 |
| 1821474776 | Jay E. Bauman Dds Apdc | Dentist | 1110 E Chapman Ave, Ste 102, Orange, CA 92866 | 2015-08-03 |
| 1659755767 | Language 2 Literacy | Speech-Language Pathologist | 1110 E Chapman Ave, Suite 203, Orange, CA 92866-2139 | 2015-07-17 |
| 1912381807 | Lori Bagai Dds Inc | Dentist | 1110 E Chapman Ave, Suite 105, Orange, CA 92866-2139 | 2015-07-10 |
| 1457665226 | Donna Armfield Hume | Social Worker | 1110 E Chapman Ave, Suite 204, Orange, CA 92866-2139 | 2010-08-03 |
| 1841430345 | Bao-thy N. Grant, D.d.s.,inc. | Clinic/Center | 1110 E Chapman Ave, Suite 100, Orange, CA 92866-2139 | 2009-02-24 |
| 1316102387 | David B. Ciminski, O.d. | Optometrist | 1110 E Chapman Ave, Suite#107, Orange, CA 92866-2139 | 2008-07-18 |
| 1760654297 | Craig J Milhouse Md Inc | Physical Medicine & Rehabilitation | 1110 E Chapman Ave, Suite 101, Orange, CA 92866-2139 | 2008-03-25 |
| 1366612954 | Bao-thy Ngoc Grant | Dentist | 1110 E Chapman Ave, Suite 100, Orange, CA 92866-2139 | 2008-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1477114122 | Beverley P Brownell | Nurse Practitioner | 1215 E. Chapman Avenue, Orange, CA 92866 | 2019-06-24 |
| 1528539442 | Brian Chau | Pharmacist | 1538 E. Chapman Ave, Orange, CA 92866 | 2018-12-17 |
| 1891214599 | Nancy Lee Mcdonald | Registered Nurse | 700 Sout Tustin, Orange, CA 92866 | 2017-09-13 |
| 1962932541 | Hao Phu Nguyen | Counselor | 401 S. Tustin Street, Building D, Orange, CA 92866 | 2017-06-15 |
| 1932567377 | Lori Lynn Hughes | Psychologist | 734 E. Chapman Ave., Suite 734, Orange, CA 92866 | 2016-01-30 |
| 1417291360 | Lori Ann Bartczak | Speech-Language Pathologist | 393 S. Tustin St., Orange, CA 92866 | 2012-11-15 |
| 1497046064 | Pacific Shore Surgery Center | Clinic/Center | 302 W. Laveta Ave, Suite 100, Orange, CA 92866 | 2011-04-29 |
| 1871805127 | Spring Medley Peavy | Nurse Practitioner | 1040 E. Chapman Ave, Orange, CA 92866 | 2010-07-01 |
| 1790956084 | Kevin Robert Franks | Dentist | 532 E Chapman Ave, Orange, CA 92866 | 2008-03-14 |
| Find all providers in zip 92866 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
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| 1770985004 | M2 Creative | Psychologist | 6715 Melrose Ave, Los Angeles, CA 90038-3411 | 2014-09-18 |
| 1508294083 | Silverlining Psychiatry Medical Group | Psychologist | 3252 Holiday Ct Ste 108, La Jolla, CA 92037-1807 | 2013-10-21 |
| 1235408089 | Behavioral Research Specialists, LLC | Psychologist | 230 N. Maryland Ave, #309, Glendale, CA 91206 | 2011-12-23 |
| 1730342957 | United Behavioral Center, Inc | Psychologist | 834 W Avenue J, Lancaster, CA 93534-3427 | 2008-07-08 |
| 1528245917 | Claude E. Arnett | Psychologist | 403 N Susan St, Santa Ana, CA 92703-3433 | 2008-01-28 |
| 1811102908 | Mary Ann Barr | Psychologist | 277 Cascade Dr, Mill Valley, CA 94941-5025 | 2007-05-11 |
| 1255544557 | Pituck Medical Group, Inc. | Psychologist | 5858 Magnolia Ave Ste C, Riverside, CA 92506-1886 | 2007-05-07 |
| 1932320389 | Ricque L. Brister | Psychologist | 56 Hanover Ln, Suite., 100, Chico, CA 95973-7230 | 2007-05-02 |
| 1013539121 | Sally Kei Mason | Psychologist | 510 Plaza Dr Ste 170, Folsom, CA 95630-4790 | 2020-05-12 |
| 1043691025 | New Day Institute | Psychologist | 6391 Magnolia Ave, Suite A, Riverside, CA 92506-2424 | 2015-06-15 |
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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.