Sunbridge Psych

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

2458 Issued in CA

Legal business name

SUNBRIDGE PSYCH

Practice address

30240 Rancho Viejo Rd Ste C1
San Juan Capistrano, CA 92675-1515

Phone

(949) 374-9245

Fax

(949) 751-2432

NPI assigned

Nov 20, 2017

Last updated

Oct 31, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Mary Ann Offenheiser, PMHCNS BCNPI 1053406025

Title

Psych Clinical Nurse Specialist

Phone

(949) 374-9245

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Ann Offenheiser, CNS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • San Juan Capistrano, CA
  • NPI 1053406025
  NPD Authorized official

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1376057802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ENTORNO ST",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941374",
            "telephone_number": "949-374-9245",
            "fax_number": "949-751-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30240 RANCHO VIEJO RD STE C1",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751515",
            "telephone_number": "949-374-9245",
            "fax_number": "949-751-2432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Entorno St",
            "address_purpose": "LOCATION",
            "city": "Rancho Mission Viejo",
            "state": "CA",
            "postal_code": "926941374",
            "country_code": "US",
            "telephone_number": "949-374-9245",
            "fax_number": "949-751-2432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNBRIDGE PSYCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "OFFENHEISER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSYCH CLINICAL NURSE SPECIALIST",
        "authorized_official_telephone_number": "949-374-9245",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHCNS BC"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CA",
            "license": "2458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Stults, D.O.
• Cassidy E Sullivan
• Kelsey Sullivan
• Sun County Wellness LLC
• Deborah Sun
• Sunfinity
• Sunshine Behavioral Health LLC (Monarch Shores)
• Surf and Turf Therapy
• Victoria Ta
• Dorothy A Tagan, RN CPNP

• Psychiatric/Mental Health Clinical Nurse Specialist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in California

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