Experience Recovery Iop

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

EXPERIENCE RECOVERY IOP

Practice address

5405 Garden Grove Blvd Ste 101
Westminster, CA 92683-1887

Phone

(714) 713-5272

NPI assigned

Mar 29, 2017

Organization subpart

No

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

Authorized official

Name

Ann Premazon

Title

Owner

Phone

(714) 865-1052

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1235661315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 W HAZARD AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032625",
            "telephone_number": "714-865-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 GARDEN GROVE BLVD STE 101",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926831887",
            "telephone_number": "714-713-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE RECOVERY IOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "PREMAZON",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-865-1052"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Espinoza
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• Substance Abuse Rehabilitation Facility in Westminster, CA
• Providers in Westminster, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.