STEPHENIE R CHAMPLIN (NPI# 1710257936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710257936 |
| Entity Type | Individual |
| Full Name | STEPHENIE R CHAMPLIN |
| Credential | MSW, LCSW |
| Practice Address |
3505 Cadillac Ave Bldg O, Suite 109 Costa Mesa CA 92626-1429 |
| Practice Telephone | 7144329856 |
| Practice Fax Number | 7144327075 |
| Mailing Telephone | 7144329856 |
| Mailing Fax Number | 7144327075 |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2016-11-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW 74243 | CA | Behavioral Health & Social Service Providers |
| Street Address |
3505 CADILLAC AVE BLDG O, SUITE 109 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-1429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760428072 | Therese Louise Wright | Nurse Practitioner | 3505 Cadillac Ave, Costa Mesa, CA 92626-1429 | 2006-06-22 |
| 1366984213 | Pathways To Wellness | Community/Behavioral Health | 3505 Cadillac Ave, Building O, Suite 109, Costa Mesa, CA 92626-1429 | 2016-11-09 |
| 1538452297 | Marshall B. Stamper | Family Medicine | 3505 Cadillac Ave, Costa Mesa, CA 92626-1429 | 2011-05-27 |
| 1518158831 | Mary Jane Pageau | Nurse Practitioner | 3505 Cadillac Ave, Bldg O, Suite 110, Costa Mesa, CA 92626-1429 | 2007-08-05 |
| 1255539912 | Carolyn D Gale | Dietary Manager | 3505 Cadillac Ave, Suite N-2, Costa Mesa, CA 92626-1429 | 2007-07-04 |
| 1649474545 | Shelly Rebecca Lummus | Nurse Practitioner | 3505 Cadillac Ave, Building O Suite 110, Costa Mesa, CA 92626-1429 | 2007-06-13 |
| 1205862224 | Nancy D Young | Psychologist | 3505 Cadillac Ave, Bldg O, Suite 109, Costa Mesa, CA 92626-1429 | 2006-06-23 |
| 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 | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225642531 | Inner Wisdom Psychotherapy Assoc., Inc | Social Worker | 1006 Katama Bay Dr, Costa Mesa, CA 92627-9030 | 2020-09-03 |
| 1902429194 | Katharine Burgess | Social Worker | 2330 Vanguard Way Apt Q106, Costa Mesa, CA 92626-6583 | 2020-05-21 |
| 1003438433 | Joseph Madrid | Social Worker | 252 16th Pl Apt C, Costa Mesa, CA 92627-9410 | 2020-05-07 |
| 1699242677 | Gracielle Joyce Dalisay | Social Worker | 2973 Harbor Blvd # 462, Costa Mesa, CA 92626-3912 | 2018-10-29 |
| 1891209185 | Holly L Stefani | Social Worker | 288 Sherwood St, Costa Mesa, CA 92627-2160 | 2017-11-22 |
| 1073047296 | Sally Patricia Morris | Social Worker | 252 Hill Pl, Costa Mesa, CA 92627-1313 | 2017-04-13 |
| 1013363159 | Shelley Beckham | Social Worker | 271 Mesa Dr, Costa Mesa, CA 92627-4622 | 2016-05-08 |
| 1396111746 | Janet Mcdavid | Social Worker | 2569 Greenbriar Ln, Costa Mesa, CA 92626-6115 | 2015-08-19 |
| 1851790968 | Esteban Juarez | Social Worker | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2014-08-14 |
| 1497174577 | Tracy Phelps | Social Worker | 2164 Canyon Dr Apt J, Costa Mesa, CA 92627-4899 | 2014-04-15 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.