Prembo LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

PREMBO LLC

Practice address

23711 Via Navarra
Mission Viejo, CA 92691-3637

Phone

(760) 409-7544

NPI assigned

Nov 29, 2021

Organization subpart

No

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

Authorized official

Name

Preston Jack Durnford

Title

Ceo/Owner

Phone

(760) 409-7544

Specialties & licenses 1

Addresses

Other names 1

• SoCal Mental Health Doing business as

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1093473837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CORPORATE PARK STE C-200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065146",
            "telephone_number": "760-409-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23711 VIA NAVARRA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913637",
            "telephone_number": "760-409-7544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26842 Primavera Dr",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926915205",
            "country_code": "US",
            "telephone_number": "760-409-7544",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 Drake Ave",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928321140",
            "country_code": "US",
            "telephone_number": "760-409-7544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMBO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "DURNFORD",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "760-409-7544"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoCal Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SoCal Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pour Monajem Zadeh Dental Mission Viejo Inc
• Deborah Jo Powers Neighbors, LMFT
• Donald J Pratt, M.D.
• Stephen James Pratt, MA, MFT
• Alexander Arthur Prattes
• Ashley Elizabeth Presley, SLP
• James Blair Price, M.D.
• Erika Prigo
• Prohealth Partners a Medical Group Inc
• Prosport Physical Therapy Professionals Inc

• Psychiatric Residential Treatment Facility in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Psychiatric Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.