NPIMap

Organization Active NPI

Pathways to Wellness, a Psychotherapy Professional Corporation

  • Clinical Psychologist
  • Costa Mesa, CA
National Provider Identifier
1508524844
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PATHWAYS TO WELLNESS, A PSYCHOTHERAPY PROFESSIONAL CORPORATION
Practice address
3505 Cadillac Ave # O-109
Costa Mesa, CA 92626-1429
Phone
(714) 432-9856
Fax
(714) 432-7075
NPI assigned
Dec 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Authorized official

Name
Nancy D Young, PHDNPI 1205862224
Title
Owner/Clinical Psychologist
Phone
(714) 432-9856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

3505 Cadillac Ave # O-109
Costa Mesa, CA 92626-1429

Mailing address

3505 Cadillac Ave # O-109
Costa Mesa, CA 92626-1429
Phone (714) 432-9856

Other names 1

  • Pathways to Wellness Other name

National Provider Directory

National Provider Directory

Locations

3505 Cadillac Ave
#O109
Costa Mesa, CA 92626
Phone (714) 432-9856

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1508524844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 CADILLAC AVE # O-109",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261429",
            "telephone_number": "714-432-9856",
            "fax_number": "714-432-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 CADILLAC AVE # O-109",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261429",
            "telephone_number": "714-432-9856",
            "fax_number": "714-432-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS TO WELLNESS, A PSYCHOTHERAPY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "714-432-9856",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathways to Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 3, 2021; 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.