Organization Active NPI

Alta Connect Carellc

  • Mental Health Counselor
  • Costa Mesa, CA
National Provider Identifier
1386112647
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ALTA CONNECT CARELLC
Practice address
2900 Bristol St # 206
Costa Mesa, CA 92626-5981
Phone
(949) 302-9767
NPI assigned
Nov 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Authorized official

Name
Maren Earn
Title
Manager
Phone
(949) 302-9767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2900 Bristol St # 206
Costa Mesa, CA 92626-5981

Mailing address

2900 Bristol St # 206
Costa Mesa, CA 92626-5981
Phone (949) 302-9767

National Provider Directory

National Provider Directory

Locations

2900 Bristol St
#206
Costa Mesa, CA 92626
Phone (949) 302-9767

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541376000000",
    "number": "1386112647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST # 206",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "949-302-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST # 206",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "949-302-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA CONNECT CARELLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A",
        "authorized_official_last_name": "EARN",
        "authorized_official_first_name": "MAREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "949-302-9767"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.