1265869523 NPI number — CALIFORNIA THERAPY SOLUTIONS

Table of content: (NPI 1265869523)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265869523 NPI number — CALIFORNIA THERAPY SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA THERAPY SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265869523
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
485 E 17TH ST STE 650
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COSTA MESA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92627-4706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-722-7374
Provider Business Mailing Address Fax Number:
949-722-7700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18682 BEACH BLVD STE 130
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92648-2094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-963-6600
Provider Business Practice Location Address Fax Number:
714-963-6900
Provider Enumeration Date:
10/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
COX
Authorized Official First Name:
BREE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
ADMINISTRATION/PATIENT ACCOUNT MGR
Authorized Official Telephone Number:
949-432-3731

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  W15163 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: W15163 . This is a "SUPPLIER BILLING NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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