NPIMap

Organization Active NPI

Phoenix House Orange County, Inc.

  • Substance Abuse Rehabilitation Facility
  • Santa Ana, CA
National Provider Identifier
1295812626
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
300033AN Issued in CA
Legal business name
PHOENIX HOUSE ORANGE COUNTY, INC.
Practice address
1207 E Fruit St
Santa Ana, CA 92701-4206
Phone
(714) 953-9373
Fax
(714) 953-7573
NPI assigned
Nov 1, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Shawna Renee Morris
Title
Senior Vice President & Executive D
Phone
(818) 686-3011

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 300605606 CA
Substance Abuse Rehabilitation Facility 324500000X 300033AN CA Primary
Substance Abuse Rehabilitation Facility 324500000X 300033CN CA
Children's Substance Abuse Rehabilitation Facility 3245S0500X 300605606 CA

Addresses

Primary practice location

1207 E Fruit St
Santa Ana, CA 92701-4206

Mailing address

11600 Eldridge Ave
Lake View Terrace, CA 91342-6506
Phone (818) 686-3000

Other identifiers 3

IdentifierTypeStateIssuer
300605606OtherCASTATE LICENSE NUMBER- ADP
1612OtherCACALIFORNIA
8047OtherCADRUG MEDI-CAL PROVIDER NUMB

National Provider Directory

National Provider Directory
Tax ID family
Phoenix House Orange County Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1207 E Fruit St
Santa Ana, CA 92701
Phone (714) 953-9373

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1295812626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 ELDRIDGE AVE",
            "city": "LAKE VIEW TERRACE",
            "state": "CA",
            "postal_code": "913426506",
            "telephone_number": "818-686-3000",
            "fax_number": "818-896-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "714-953-9373",
            "fax_number": "714-953-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSE ORANGE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & EXECUTIVE D",
        "authorized_official_telephone_number": "818-686-3011",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "300605606",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300033AN",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300033CN",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "CA",
            "license": "300605606",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER- ADP",
            "identifier": "300605606",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA",
            "identifier": "1612",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL PROVIDER NUMB",
            "identifier": "8047",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.