Changing Tides Treatment LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CHANGING TIDES TREATMENT LLC

Practice address

2021 Sperry Ave
Suite 3
Ventura, CA 93003-7408

Phone

(844) 883-3869

NPI assigned

Jan 23, 2015

Organization subpart

No

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

Authorized official

Name

Berkeley Beaudean Dains, CATC, CIP,BS

Title

Ceo

Phone

(805) 506-1541

Specialties & licenses 4

Addresses

Tax ID family

Changing Tides Treatment LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Chaning Tides Treatment

  • Addiction Medicine (Family Medicine) Physician
  • Ventura, CA
  • NPI 1508315250
  NPD tax ID

Locations

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1053701425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 SEABREEZE WAY",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351048",
            "telephone_number": "844-883-3869",
            "fax_number": "805-624-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SPERRY AVE",
            "address_2": "SUITE 3",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037408",
            "telephone_number": "844-883-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "DAINS",
        "authorized_official_first_name": "BERKELEY",
        "authorized_official_middle_name": "BEAUDEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-506-1541",
        "authorized_official_credential": "CATC, CIP,BS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Chang, LVN
• Diana Juhee Chang
• Kyung Sook Chang
• Li-Wen Chang
• Steven David Chang, M.D.
• Chaning Tides Treatment
• Channel Islands Prosthetics-Orthotics
• Channel Islands Rehab, LLC
• Channel Islands Rehab, LLC
• Audree Chapman, LMFT

• Substance Use Disorder Rehabilitation Clinic/Center in Ventura, CA
• Providers in Ventura, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.