NPIMap

Organization Active NPI

California Diversion Intervention Foundation

  • Addiction (Substance Use Disorder) Counselor
  • Orange, CA
National Provider Identifier
1154410652
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
300125BN Issued in CA
Legal business name
CALIFORNIA DIVERSION INTERVENTION FOUNDATION
Practice address
1095 N Main St
Suite B
Orange, CA 92867-5476
Phone
(714) 633-0502
Fax
(714) 633-9249
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Mr. Harry K. Miyaji
Title
Program Director
Phone
(714) 633-0502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 300125BN CA Primary

Addresses

Primary practice location

1095 N Main St
Suite B
Orange, CA 92867-5476

Mailing address

1095 N Main St
Suite B
Orange, CA 92867-5476
Phone (714) 633-0502

Other identifiers 1

IdentifierTypeStateIssuer
300125BNOtherCAOUTPATIENT CERTIFICATION

National Provider Directory

National Provider Directory

Locations

1095 N Main St
Ste B
Orange, CA 92867
Phone (714) 633-0502

Practitioners & affiliated clinicians

Practitioners 6

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1154410652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 N MAIN ST",
            "address_2": "SUITE B",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675476",
            "telephone_number": "714-633-0502",
            "fax_number": "714-633-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 N MAIN ST",
            "address_2": "SUITE B",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675476",
            "telephone_number": "714-633-0502",
            "fax_number": "714-633-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DIVERSION INTERVENTION FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "MIYAJI",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "714-633-0502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "300125BN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT CERTIFICATION",
            "identifier": "300125BN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.