Active NPI
Alta Connect Carellc
- Mental Health Counselor
- Costa Mesa, CA
National Provider Identifier
1386112647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 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 DirectoryLocations
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.