Organization Active NPI

Transformation Health & Wellness

  • Gynecology Physician
  • Anaheim, CA
National Provider Identifier
1003420381
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
TRANSFORMATION HEALTH & WELLNESS
Practice address
6200 E Canyon Rim Rd Ste 105B
Anaheim, CA 92807-4313
Phone
(714) 900-3091
Fax
(714) 386-5147
NPI assigned
Sep 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jacquelyn Diane Cortez, DO
Title
President
Phone
(714) 900-3091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

6200 E Canyon Rim Rd Ste 105B
Anaheim, CA 92807-4313

Mailing address

6200 E Canyon Rim Rd Ste 105B
Anaheim, CA 92807-4313
Phone (714) 900-3091

Other identifiers 1

IdentifierTypeStateIssuer
1982732236OtherCANPI

Other names 1

  • Transformation Health & Wellness Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Dr.Chrono

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2203373Transformation Health & Wellness6200 Canyon Rim Rd 105 B, Anaheim, CA 92807Certificate of waiverDec 2, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1003420381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 E CANYON RIM RD STE 105B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074313",
            "telephone_number": "714-900-3091",
            "fax_number": "714-386-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 E CANYON RIM RD STE 105B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074313",
            "telephone_number": "714-900-3091",
            "fax_number": "714-386-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "CORTEZ",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-900-3091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982732236",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Dr.Chrono",
            "affiliation": "N",
            "endpointDescription": "Dr.Chrono",
            "address_1": "6200 E Canyon Rim Rd Ste 105B",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928074313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Transformation Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.