Evernorth Direct Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVERNORTH DIRECT HEALTH LLC

Practice address

400 W Civic Center Dr Ste 111
Santa Ana, CA 92701-4539

Phone

(602) 277-1190

NPI assigned

Oct 10, 2022

Organization subpart

Yes

Parent organization

EVERNORTH DIRECT HEALTHAs reported in NPPES

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

Authorized official

Name

Deborah Sue Coolidge

Title

Financial Analysis Senior Manager

Phone

(623) 277-1170

Specialties & licenses 1

Addresses

Other names 1

• County of Orange Behavioral Health Other name

Tax ID family

Evernorth Direct Health LLC102 organizations share this tax ID, including this one

Part of

Evernorth Direct Health LLC

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Evernorth Direct Health LLC

  • Clinic/Center
  • San Diego, CA
  • NPI 1053288894
  NPD tax ID
• Evernorth Direct Health LLC

  • Clinic/Center
  • Orange, CA
  • NPI 1104645118
  NPD tax ID

Locations

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1487379640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25600 N NORTERRA DR BLDG A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858201",
            "telephone_number": "480-589-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CIVIC CENTER DR STE 111",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014539",
            "telephone_number": "602-277-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERNORTH DIRECT HEALTH",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "FINANCIAL ANALYSIS SENIOR MANAGER",
        "authorized_official_telephone_number": "623-277-1170"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "County of Orange Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Domel Briones Evangelista
• Carl Edward Evans
• Janaeya Marie Evans
• Lindsey Evelyn, RD
• Danielle Everly
• Lynette Dee Ewing, PSYCHIATRIC TECH.
• Tanji Ewing, MA, LMFT
• Executive Hand Therapy, Inc.
• Experience Recovery Detox & Residential LLC.
• Experience Recovery Detox & Residential LLC.

• Clinic/Center in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.