Neurodivergent Psychiatric Specialists

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NEURODIVERGENT PSYCHIATRIC SPECIALISTS

Practice address

2112 E 4TH St
Ste 228a
Santa Ana, CA 92705-3840

Phone

(949) 409-6460

Fax

(949) 749-7433

NPI assigned

Jul 10, 2025

Organization subpart

No

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

Authorized official

Name

Jesse Anthony Bonilla, PMHNPNPI 1689440711

Title

Executive Officer

Phone

(714) 420-9890

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Neurodivergent Psychiatric Specialists Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: jab@mcsl-ca.direct.office.nextgen.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Anthony Bonilla, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
  • NPI 1689440711
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1417848219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 E 4TH ST STE 228",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053840",
            "telephone_number": "949-409-6460",
            "fax_number": "949-749-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 E 4TH ST",
            "address_2": "STE 228A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053840",
            "telephone_number": "949-409-6460",
            "fax_number": "949-749-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODIVERGENT PSYCHIATRIC SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "BONILLA",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-420-9890",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CB540002",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JAB@MCSL-CA.direct.office.nextgen.com",
            "affiliation": "N",
            "endpointDescription": "NextGen Direct Secure Messaging for Neurodivergent Psychiatric Specialists telehealth clinic.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Secure exchange of patient care summaries, referrals, and clinical attachments",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Clinical care records, transitionof care summaries, lab results",
            "address_1": "2112 E 4th St Ste 228A",
            "city": "Santa Ana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927053840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Neurodivergent Psychiatric Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Marie Nenni, MA, MS
• Barbara Nesbitt
• Net RX Inc
• Gail Neuman, RN, FNP
• Ronald Charles Neuman, MD
• Neurology Doctors of California, Inc.
• Neurology Evaluation Centers, Professional Corp.
• Neuropsychology Assessment Services, a Psychological Corporation
• Neurospectrum Alliance LLC
• Ariana Nevarez

• Internal Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.