BREAKAWAY HEALTH CORPORATION (NPI# 1851474225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851474225 |
| Entity Type | Organization |
| Organization Name | BREAKAWAY HEALTH CORPORATION |
| Practice Address |
3151 Airway Ave D-1 Costa Mesa CA 92626-4607 |
| Mailing Address |
28251 Millwood Rd Trabuco Canyon CA 92679-1214 |
| Practice Telephone | 7149578229 |
| Practice Fax Number | 7149570244 |
| Mailing Telephone | 7142920707 |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RICHARD PATRICK PLASKETT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7149578229 |
| Authorized Official Credential | MASTERS, FORENSI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
300065A | CA | Behavioral Health & Social Service Providers |
| Street Address |
3151 AIRWAY AVE D-1 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609836469 | Eric A Prouty | Dentist | 3151 Airway Ave, Suite M2, Costa Mesa, CA 92626-4607 | 2006-03-24 |
| 1609342567 | Chris Maa | Acupuncturist | 3151 Airway Ave, Costa Mesa, CA 92626-4607 | 2018-10-18 |
| 1518319946 | Alisa Gardner | Social Worker | 3151 Airway Ave, T2, Costa Mesa, CA 92626-4607 | 2016-07-09 |
| 1821449141 | Nicole Krakora | Naturopath | 3151 Airway Ave, Suite U-3, Costa Mesa, CA 92626-4607 | 2016-06-28 |
| 1841646809 | Charles Fagenholz | Chiropractor | 3151 Airway Ave, U-3, Costa Mesa, CA 92626-4607 | 2016-05-09 |
| 1275997058 | Scbh Laboratory, LLC | Clinical Medical Laboratory | 3151 Airway Ave, Suite N-1, Costa Mesa, CA 92626-4607 | 2016-04-07 |
| 1215392816 | Hpr Laboratories | Clinical Medical Laboratory | 3151 Airway Ave, Unit G1, Costa Mesa, CA 92626-4607 | 2015-12-23 |
| 1134592249 | Robin Giesen | Marriage & Family Therapist | 3151 Airway Ave, Ste. T-3, Costa Mesa, CA 92626-4607 | 2015-11-11 |
| 1194194860 | Samuel T. Enterprise | Counselor | 3151 Airway Ave, Suite D2, Costa Mesa, CA 92626-4607 | 2015-09-23 |
| 1740664614 | Clint Johnson | Counselor | 3151 Airway Ave, D-1, Costa Mesa, CA 92626-4607 | 2015-07-10 |
| Find all providers in the same location | ||||
| 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 | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407312051 | Joan Marie Franco | Counselor | 2001 Harbor Blvd Ste 200, Costa Mesa, CA 92627-8518 | 2019-02-19 |
| 1699277251 | Leslie Margarita Wilson | Counselor | 2900 Bristol St Ste 103, Costa Mesa, CA 92626-5981 | 2018-02-28 |
| 1003276700 | Claudio Nunez | Counselor | 2165 Harbor Blvd, Costa Mesa, CA 92627-2529 | 2016-02-24 |
| 1437519188 | Marsha Lynn Coxen | Counselor | 2940 Peppertree Ln Apt C, Costa Mesa, CA 92626-3850 | 2016-02-23 |
| 1821331497 | Ashley Rae Richmond | Counselor | 2001 Harbor Blvd, Suite 220, Costa Mesa, CA 92627 | 2013-04-02 |
| 1801150149 | Lynn Talmon | Counselor | 3001 Red Hill Ave. Building 2 Suite 215, Costa Mesa, CA 92627-9262 | 2012-07-02 |
| 1386907418 | Zen Recovery,llc | Counselor | 126 E 16th St, Costa Mesa, CA 92627-7704 | 2012-06-22 |
| 1578826616 | Dawn Forteville | Counselor | 2080 President Pl, Costa Mesa, CA 92627-4014 | 2012-06-22 |
| 1144463001 | Justinna Lang Taing | Counselor | 2300 Fairview Rd Apt P102, Costa Mesa, CA 92626-6483 | 2009-04-08 |
| 1588262380 | Rosario Zatarain | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2020-10-14 |
| 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.