FRESH START RECOVERY SERVICES (NPI# 1396161337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396161337 |
| Entity Type | Organization |
| Organization Name | FRESH START RECOVERY SERVICES |
| Practice Address |
2790 Harbor Blvd Suite #307 Costa Mesa CA 92626-5154 |
| Practice Telephone | 9492002341 |
| Mailing Telephone | 9492002341 |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |
| Authorized Official Name | MR. DAVID WAYNE PARKER (PRESIDENT) |
| Authorized Official Telephone | 9492002341 |
| Authorized Official Credential | LAADC, ICADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
CA | Ambulatory Health Care Facilities |
| Street Address |
2790 HARBOR BLVD SUITE #307 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-5154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609987718 | Yee-wing Tong | Anesthesiology | 2790 Harbor Blvd, Suite 300, Costa Mesa, CA 92626 | 2006-08-31 |
| 1063959591 | Mainstay Recovery | Counselor | 2790 Harbor Blvd, Suite 208, Costa Mesa, CA 92626-5154 | 2017-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144795261 | Divine Bliss, Inc. | Clinic/Center | 1219 Parnell Pl, Costa Mesa, CA 92626-2737 | 2018-10-04 |
| 1659731479 | Options, LLC | Clinic/Center | 2790 Harbor Blvd Ste 307, Costa Mesa, CA 92626-5157 | 2016-03-07 |
| 1205371341 | Miramar Health Inc | Clinic/Center | 2165 Harbor Blvd, Costa Mesa, CA 92627-2529 | 2016-12-28 |
| 1629115381 | County of Orange | Clinic/Center | 425 E 18th St, Costa Mesa, CA 92627-3161 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366078115 | Humangood Socal | Clinic/Center | 1151 S Redwood St, Escondido, CA 92025-5614 | 2020-03-12 |
| 1477192813 | Wellness Recovery Retreat Center | Clinic/Center | 1562 Meridian Ave, San Jose, CA 95125-5319 | 2020-01-02 |
| 1548818636 | Advent Healthcare Solutions, LLC | Clinic/Center | 255 W Fallbrook Ave Ste 102, Fresno, CA 93711-6151 | 2019-08-31 |
| 1770052748 | The Kibbutz - Nature Serenity Renewal | Clinic/Center | 13136 Elizabeth Lake Rd, Leona Valley, CA 93551 | 2018-11-19 |
| 1407346489 | True North Detox LLC | Clinic/Center | 2121 Herndon Ave Ste 102, Clovis, CA 93611-6302 | 2018-05-15 |
| 1851898811 | Sober First Recovery LLC | Clinic/Center | 3309 Clay St, Newport Beach, CA 92663-4208 | 2018-04-06 |
| 1306354634 | Sea Change Santa Monica, Lp | Clinic/Center | 1051 Princeton St, Santa Monica, CA 90403 | 2018-01-22 |
| 1356860738 | Destiny Recovery Center Iop | Clinic/Center | 23041 Avenida De La Carlota Ste 280, Laguna Hills, CA 92653-1531 | 2017-09-17 |
| 1073966370 | New U Beginnings Inc | Clinic/Center | 5205 Agnes Ave, Valley Village, CA 91607-2701 | 2016-07-21 |
| 1629438775 | A.k. Bean Foundation | Clinic/Center | 2100 Sacramento St, Vallejo, CA 94590-3126 | 2016-03-02 |
| Find all providers with the same taxonomy | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on FRESH START RECOVERY SERVICES.
| 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.