Syreeta Theroith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3611 S Harbor Blvd
Ste 100
Santa Ana, CA 92704-6928

Phone

(714) 966-8670

Fax

(714) 434-0559

NPI assigned

Mar 23, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1255630760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E RIVERSIDE DR",
            "address_2": "246",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617405",
            "telephone_number": "319-290-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S HARBOR BLVD",
            "address_2": "STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046928",
            "telephone_number": "714-966-8670",
            "fax_number": "714-434-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEROITH",
        "first_name": "SYREETA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "225400000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.