Organization Active NPI

Howard Medical Corp

  • Psychiatry Physician
  • San Clemente, CA
National Provider Identifier
1063887016
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HOWARD MEDICAL CORP
Practice address
101 W Avenida Vista Hermosa Ste 122
San Clemente, CA 92672-7707
Phone
(949) 212-2699
Fax
(888) 999-8503
NPI assigned
Dec 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Authorized official

Name
Dr. Eben Howard, PHD, FNP, PMHNP
Title
Ceo
Phone
(714) 697-5211

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

101 W Avenida Vista Hermosa Ste 122
San Clemente, CA 92672-7707

Mailing address

101 W Avenida Vista Hermosa Ste 122
San Clemente, CA 92672-7707
Phone (949) 212-2699

National Provider Directory

National Provider Directory

Locations

101 W Avenida Vista Hermosa
Ste 122
San Clemente, CA 92672
Phone (949) 212-2699

2738 Camino Capistrano
Ste 4
San Clemente, CA 92672
Phone (714) 697-5211

Practitioners & affiliated clinicians

Practitioners 1

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": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1063887016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W AVENIDA VISTA HERMOSA STE 122",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926727707",
            "telephone_number": "949-212-2699",
            "fax_number": "888-999-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W AVENIDA VISTA HERMOSA STE 122",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926727707",
            "telephone_number": "949-212-2699",
            "fax_number": "888-999-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "EBEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-697-5211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, FNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.