Socal Adolescent Wellness, Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

SOCAL ADOLESCENT WELLNESS, INC.

Practice address

16052 Beach Blvd Ste 135
Huntington Beach, CA 92647-3817

Phone

(402) 250-8989

NPI assigned

Aug 17, 2018

Organization subpart

Yes

Parent organization

SOCAL ADOLESCENT WELLNESS, LLC.As reported in NPPES

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

Authorized official

Name

Mr. James Sewell

Title

Coowner

Phone

(402) 240-8989

Specialties & licenses 1

Addresses

Tax ID family

Socal Adolescent Wellness Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Socal Adolescent Wellness, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Lake Forest, CA
  • NPI 1083230262
  NPD tax ID
• Socal Adolescent Wellness, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Huntington Beach, CA
  • NPI 1619551124
  NPD tax ID
• Socal Adolescent Wellness, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Lake Forest, CA
  • NPI 1972375715
  NPD tax ID

Locations

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1023598299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7641 TALBERT AVE STE 215",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926488617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16052 BEACH BLVD STE 135",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473817",
            "telephone_number": "402-250-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL ADOLESCENT WELLNESS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOCAL ADOLESCENT WELLNESS, LLC.",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "402-240-8989",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Smith, RADT-1 R1344970419
• Denise Sunny Smoke, CATC
• Natalie Smyth
• Julie Anne Snapper
• Sober Partners Beach House
• Socal Adolescent Wellness, Inc.
• Socal Beach Rehab LLC
• Socal Beach Rehab LLC
• Socal Beach Rehab LLC
• Socal Chiropractic Center PC

• Adolescent and Children Mental Health Clinic/Center in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.