NPIMap

Organization Active NPI

Indevo, Inc.

  • Substance Abuse Rehabilitation Facility
  • Irvine, CA
National Provider Identifier
1306265772
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
999999 Issued in CA
Legal business name
INDEVO, INC.
Practice address
17900 Sky Park Cir Ste 100
Irvine, CA 92614-6471
Phone
(855) 511-0855
NPI assigned
Apr 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Dr. Ehsan Gharadjedaghi, PSYD
Title
Ceo
Phone
(949) 310-2993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 999999 CA Primary

Addresses

Primary practice location

17900 Sky Park Cir Ste 100
Irvine, CA 92614-6471

Mailing address

17900 Sky Park Cir Ste 100
Irvine, CA 92614-6471
Phone (855) 511-0855

Other names 1

  • INDEVO Treatment Partners Doing business as

National Provider Directory

National Provider Directory

Locations

17900 Sky Park Cir
Ste 100
Irvine, CA 92614
Phone (949) 242-9720

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1306265772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 SKY PARK CIR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146471",
            "telephone_number": "855-511-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 SKY PARK CIR STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146471",
            "telephone_number": "855-511-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEVO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "GHARADJEDAGHI",
        "authorized_official_first_name": "EHSAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-310-2993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "999999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDEVO Treatment Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.