NPIMap

Organization Active NPI

County of Orange

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Ana, CA
National Provider Identifier
1104963347
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COUNTY OF ORANGE
Practice address
405 W 5TH St Ste 212
Santa Ana, CA 92701-4522
Phone
(714) 568-5614
NPI assigned
Jan 30, 2007
Organization subpart
Yes
Parent organization
COUNTY OF ORANGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Kelly Kathleen Sabet, LCSW, CHC,CHPC,CHRC
Title
Chief Compliance Officer
Phone
(714) 581-7769

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
State or Local Public Health Clinic/Center 261QP0905X
Physical Therapy Clinic/Center 261QP2000X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Clinical Medical Laboratory 291U00000X
Nursing Facility/Intermediate Care Facility 313M00000X

Addresses

Primary practice location

405 W 5TH St Ste 212
Santa Ana, CA 92701-4522

Mailing address

405 W 5TH St Ste 212
Santa Ana, CA 92701-4522
Phone (714) 568-5614

Other names 1

  • Health Care Agency Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000447 CA Part B Supplier - Clinic/Group Practice 1951215789 Receives reassigned benefits from 112 practitioners
26 other NPIs on this enrollment
Practice locations: Westminster, CA; Santa Ana, CA; Orange, CA; Fullerton, CA; Costa Mesa, CA; Anaheim, CA; Aliso Viejo, CA; Mission Viejo, CA

National Provider Directory

National Provider Directory
Tax ID family
Human Services Agency42 organizations share this tax ID, including this one
Part of
Human Services Agency

Other organizations with this tax ID 41

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

View all 41

Locations

5 Mareblu
#200
Aliso Viejo, CA 92656
Phone (949) 643-6901

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

Practitioners 120

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

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1104963347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST STE 212",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014522",
            "telephone_number": "714-568-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST STE 212",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014522",
            "telephone_number": "714-568-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ORANGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF ORANGE",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SABET",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "714-581-7769",
        "authorized_official_credential": "LCSW, CHC,CHPC,CHRC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Care Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health Care Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.