WIRED CLEAN, LLC (NPI# 1568994515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568994515 |
| Entity Type | Organization |
| Organization Name | WIRED CLEAN, LLC |
| Practice Address |
1650 Adams Ave Costa Mesa CA 92626-4958 |
| Practice Telephone | 9492589219 |
| Mailing Telephone | 9492589219 |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | LEE HEILIGMAN (CEO) |
| Authorized Official Telephone | 9492589219 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
1650 ADAMS AVE |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831295823 | Gregory Ralph Bonomo | Psychiatry & Neurology | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2006-09-16 |
| 1013561752 | Tiffany Tabares | Counselor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2019-07-31 |
| 1821642570 | Anasa Jamala Storay-demby | Counselor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2019-07-31 |
| 1003155896 | Clean Testing Services | Clinical Medical Laboratory | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2013-02-14 |
| 1639323520 | South Coast Rehabilitation Center | Chiropractor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2008-11-05 |
| 1134259468 | Griffin Medical Group | Specialist | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2007-03-06 |
| 1033251418 | Alan Craig Ivar | Chiropractor | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2007-02-13 |
| 1629158514 | Alvin M Yee | General Practice | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2006-10-16 |
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1194222547 | Olive Crest | Community/Behavioral Health | 275 Victoria St Ste 2m, Costa Mesa, CA 92627-1906 | 2018-04-11 |
| 1437665130 | Partnership for Education & Professional Development | Community/Behavioral Health | 2915 Red Hill Ave Ste C102, Costa Mesa, CA 92626-5930 | 2017-12-18 |
| 1295253300 | Center for Human Potential LLC | Community/Behavioral Health | 3151 Airway Ave Ste P3, Costa Mesa, CA 92626-4626 | 2017-09-08 |
| 1508256652 | Telcare Corporation | Community/Behavioral Health | 275 Baker St E Ste A, Costa Mesa, CA 92626-4566 | 2015-01-28 |
| 1265794986 | Behavior Functions, Inc | Community/Behavioral Health | 3303 Harbor Blvd Ste B9, Costa Mesa, CA 92626 | 2012-06-08 |
| 1467718650 | Creative Family Coaching Inc. | Community/Behavioral Health | 2111 Orange Ave, B, Costa Mesa, CA 92627-1848 | 2012-04-02 |
| 1689804874 | South Coast Children's Society, Inc. | Community/Behavioral Health | 3344 Nevada Ave, Costa Mesa, CA 92626-2022 | 2009-07-22 |
| 1518110246 | Lifelines Counseling & Family Services, Inc. | Community/Behavioral Health | 3001 Red Hill Ave, #1-216, Costa Mesa, CA 92626-4529 | 2008-10-28 |
| 1770089070 | Thrive Counseling and Conciliation | Community/Behavioral Health | 1625 White Oak St, Costa Mesa, CA 92626-3724 | 2018-04-04 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on WIRED CLEAN, LLC.
| 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.