PAIN RECOVERY MEDICAL GROUP, INC (NPI# 1841683984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841683984 |
| Entity Type | Organization |
| Organization Name | PAIN RECOVERY MEDICAL GROUP, INC |
| Other Organization Name | HEADRICK INTEGRATIVE HEALING |
| Practice Address |
34085 Pacific Coast Hwy #203 Dana Point CA 92629-2764 |
| Mailing Address |
Po Box 6747 Huntington Beach CA 92615-6747 |
| Practice Telephone | 7143773749 |
| Practice Fax Number | 7143775642 |
| Mailing Telephone | 7143773749 |
| Mailing Fax Number | 7143775642 |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |
| Authorized Official Name | RENEE FULLER (BUSINESS MANAGER) |
| Authorized Official Telephone | 5623080461 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Headrick Integrative Healing | Doing Business As Name - Organization |
| Street Address |
34085 PACIFIC COAST HWY #203 |
| City | DANA POINT |
| State | CA |
| Zip Code | 92629-2764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003443144 | Torrey Dawn Commisso | Counselor | 34092 Violet Lantern, Suite 100, Dana Point, CA 92629 | 2020-03-26 |
| 1104466473 | Kirsten Noelle Yackley | Marriage & Family Therapist | 34202 Del Obispo, Dana Point, CA 92629 | 2020-01-14 |
| 1154971653 | Alicia Jolieta Ciriani | Technician | 25082 Perch Dr., Dans Point, CA 92629 | 2019-09-17 |
| 1821640137 | L Snyder Incorporated | Family Medicine | 34052 La Plaza #101, Dana Point, CA 92629 | 2019-07-16 |
| 1023572609 | Michelle Shickler | Behavioral Analyst | 32565 Golden Lantern Suite B #180, Dana Point, CA 92629 | 2019-01-28 |
| 1649734427 | Gustavo Asencia | Behavioral Analyst | 32565 Golden Lantern Ste B180, Dana Point, CA 92629 | 2019-01-25 |
| 1275069684 | Mission Rehab, LLC. | Substance Abuse Rehabilitation Facility | 32656 Golden Lantern, Suite B #473, Dana Point, CA 92629 | 2017-05-04 |
| 1922548452 | Dana Point Rehab Campus | Substance Abuse Rehabilitation Facility | 33842 Orilla Rd, Dana Point, CA 92629 | 2017-03-02 |
| 1316340060 | Steven Edward Dunbar | Chiropractor | 32585 Golden Lantern St. Suite H, Dana Point, CA 92629 | 2014-10-08 |
| 1427476183 | Lorraine Ann Sherrie | Occupational Therapy Assistant | 24242 La Cresta, Ot Department, Dana Point, CA 92629 | 2014-03-31 |
| Find all providers in zip 92629 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639618218 | California Rehab Campus LLC | Clinic/Center | 33861 Granada Dr, Dana Point, CA 92629 | 2017-02-16 |
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| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
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| Find all providers with the same taxonomy | ||||
| City | DANA POINT |
| Zip Code | 92629 |
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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.