PHOENIX HEALING ARTS (NPI# 1427368687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427368687 |
| Entity Type | Organization |
| Organization Name | PHOENIX HEALING ARTS |
| Practice Address |
22762 Aspan Street #207 Lake Forest CA 92630 |
| Practice Telephone | 8007591930 |
| Mailing Telephone | 8007591930 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |
| Authorized Official Name | MR. MATHEW CARVER (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 8007591930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
CA | Ambulatory Health Care Facilities | |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CA | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOENIX HEALING ARTS | 1139 E Eva St, Phoenix, AZ 85020-2638 |
| Street Address |
22762 ASPAN STREET #207 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790398170 | Still Water Wellness Group | Counselor | 23591 El Toro Rd Ste 200, Lake Forest, CA 92630-8616 | 2020-08-26 |
| 1205457827 | Bridget Chadwick | Counselor | 24016 Elrond Ln, Lake Forest, CA 92630-3649 | 2020-05-05 |
| 1598293854 | New Life Addiction Treatment Center Inc. | Counselor | 24882 Stem Ave, Lake Forest, CA 92630-5224 | 2017-05-31 |
| 1154789766 | 12 South LLC | Counselor | 23712 Birtcher Dr, Lake Forest, CA 92630-1771 | 2016-02-10 |
| 1396978508 | Cherie Knopf | Counselor | 26115 Sally Dr, Lake Forest, CA 92630-5540 | 2009-09-03 |
| 1396394623 | Nancy Watson | Counselor | 240 E Illinois Rd, Lake Forest, IL 60045-1943 | 2019-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1538760871 | Ky Washington | Counselor | 1625 Sweetwater Rd # C1, National City, CA 91950-7647 | 2020-11-03 |
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1548869266 | Yama Totakhail | Counselor | 915 Bryant St # 94103, San Francisco, CA 94103-4514 | 2020-10-23 |
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1285233155 | Alaric Fairchild | Counselor | 1400 N Johnson Ave Ste 1011400n, El Cajon, CA 92020-1650 | 2020-10-21 |
| 1487253571 | Roxanne Rene Coito | Counselor | 1919 Apple St # D, Oceanside, CA 92054-4425 | 2020-10-20 |
| 1255939732 | Diana Palencia | Counselor | 44459 10th St W, Lancaster, CA 93534-3324 | 2020-10-15 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| Find all providers with the same taxonomy | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
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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.