Point Break Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

POINT BREAK RECOVERY LLC

Doing business as

Point Break Recovery

Practice address

2100 Pierpont Blvd
Ventura, CA 93001-3861

Phone

(805) 415-2441

NPI assigned

Mar 2, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Martin, PSY.D.

Title

Managing Member

Phone

(805) 813-1659

Specialties & licenses 1

Addresses

Other names 1

• Point Break Recovery Doing business as

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1255030813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DUVALI DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032151",
            "telephone_number": "805-628-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PIERPONT BLVD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013861",
            "telephone_number": "805-415-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POINT BREAK RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "805-813-1659",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Point Break Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Point Break Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mara Pober, BCBA
• Heather Poehler
• Aimee Beth Pointner, PTA
• Jenica Polakow, LCSW
• Shelcy Adriana Polanco
• Daisy Polido, LMFT
• Dillon Polito, MD

• Substance Abuse Rehabilitation Facility in Ventura, CA
• Providers in Ventura, 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 Jun 24, 2024; 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.