SAN PEDRO HEALING ARTS MEDICAL CLINIC INC (NPI# 1538549563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538549563 |
| Entity Type | Organization |
| Organization Name | SAN PEDRO HEALING ARTS MEDICAL CLINIC INC |
| Practice Address |
22706 Aspan St Suite 702 Lake Forest CA 92630-1603 |
| Mailing Address |
1366 W 7th St Suite 4b San Pedro CA 90732-3500 |
| Practice Telephone | 9494271013 |
| Mailing Telephone | 3105472197 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |
| Authorized Official Name | STEPHANIE FIAMENGO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3105472197 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
PCCI 1592 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487735221 | San Pedro Healing Arts Medical Clinic Inc | Marriage & Family Therapist | 1366 W 7th St, Suite 4b, San Pedro, CA 90732-3500 | 2006-10-18 |
| Street Address |
22706 ASPAN ST SUITE 702 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669575288 | Ronald Anthony Salupo | Chiropractor | 22706 Aspan St, Ste 702, Lake Forest, CA 92630 | 2006-09-07 |
| 1801302021 | Parnian Paymozd Yazdi | Dentist | 22706 Aspan St, Lake Forest, CA 92630-1603 | 2017-12-26 |
| 1477094282 | Spine & Joint Clinic of Orange County | Chiropractor | 22706 Aspan St, Suite #702, Lake Forest, CA 92630-1603 | 2017-03-13 |
| 1598027096 | The Giving Chi Acupuncture & Wellness Center | Acupuncturist | 22706 Aspan St, #504, Lake Forest, CA 92630-1603 | 2012-06-11 |
| 1033422761 | Ark Acupuncture & Herb Prof. Corp. | Naprapath | 22706 Aspan St, Suite 504, Lake Forest, CA 92630-1603 | 2010-07-22 |
| 1073832705 | Arezou Goshtasbi | Dentist | 22706 Aspan St, Suite 602, Lake Forest, CA 92630-1603 | 2010-05-20 |
| 1396069365 | Eric Allen Carlisle | Acupuncturist | 22706 Aspan St, Suite 504, Lake Forest, CA 92630-1603 | 2010-03-19 |
| 1225369788 | Sunny Yuanwan Yang | Acupuncturist | 22706 Aspan St, #504, Lake Forest, CA 92630-1603 | 2010-01-23 |
| 1497084024 | Cheng-jung Chen | Acupuncturist | 22706 Aspan St, Suite 504, Lake Forest, CA 92630-1603 | 2009-12-10 |
| 1033236484 | Kathy Maasoumi D.d.s Inc. | Dentist | 22706 Aspan St, Suite 602, Lake Forest, CA 92630-1603 | 2007-03-23 |
| Find all providers in the same location | ||||
| 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 | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487901211 | Leah Schwartz | Counselor | 588 E Deerpath, Lake Forest, IL 60045-2202 | 2012-08-10 |
| 1154658730 | Alisa Courtney Psychotherapy | Counselor | 222 Wisconsin Ave, Suite 203b, Lake Forest, IL 60045 | 2009-11-03 |
| 1841423381 | Jennifer Ann Daniels | Counselor | 1330 Kurtis Ln, Lake Forest, IL 60045-4305 | 2009-09-01 |
| 1508950221 | Froda Gale Brotemarkle | Counselor | 23591 El Toro Rd Ste 214, Lake Forest, CA 92630-4745 | 2006-10-03 |
| 1811548928 | Miriam Stephens Drake | Counselor | 23832 Rockfield Blvd, 160, Lake Forest, CA 92630 | 2019-09-20 |
| 1093171274 | Melissa M Carava | Counselor | 222 E Wisconsin Ave Ste 203b, Lake Forest, IL 60045 | 2016-01-04 |
| 1982836177 | Jill Suzanne Kreller | Counselor | 225 E Deerpath, Suite 280, Lake Forest, IL 60045-1952 | 2009-08-20 |
| 1962523738 | Gayle Bondy | Counselor | 23591 El Toro Rd, Ste 106, Lake Forest, CA 92630-4774 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982781 | Doris J Dweh | Counselor | 12642 Memorial Way Apt 3100, Moreno Valley, CA 92553-7591 | 2020-11-05 |
| 1184225260 | Suzette Vega | Counselor | 10018 Downey Sanford Bridge Rd, Downey, CA 90240-3556 | 2020-11-04 |
| 1548860497 | Roger A Thrush | Counselor | 7777 Alvarado Rd Ste 257, La Mesa, CA 91942-8318 | 2020-10-29 |
| 1891395026 | Hayley Nasrallah | Counselor | 11712 Moorpark St Ste 101, Studio City, CA 91604-2155 | 2020-10-27 |
| 1831796978 | Geri Ann Delarosa | Counselor | 1521a Shattuck Ave, Berkeley, CA 94709-1516 | 2020-10-01 |
| 1659988822 | Katherine Beus Cusumano | Counselor | 11975 N Davis Rd, Lodi, CA 95242-9425 | 2020-09-30 |
| 1821605379 | Jacquelan Addesan King | Counselor | 124 5th St Apt A, Seal Beach, CA 90740-8000 | 2020-09-29 |
| 1225645807 | Jordan Martin | Counselor | 4065 Glencoe Ave, Marina Del Rey, CA 90292-4600 | 2020-09-28 |
| 1972110807 | Stefany Jasmin Zacarias | Counselor | 809 S Marengo Ave, Pasadena, CA 91106-3607 | 2020-09-24 |
| 1619582558 | Vanessa Diaz Venegas | Counselor | 8554 Clarinda Ave, Pico Rivera, CA 90660-5701 | 2020-09-08 |
| Find all providers with the same taxonomy | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on SAN PEDRO HEALING ARTS MEDICAL CLINIC INC.
| 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.