Socal Behavioral Health Professional Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2780787 Issued in CA

Legal business name

SOCAL BEHAVIORAL HEALTH PROFESSIONAL CORPORATION

Practice address

601 Parkcenter Dr
Suite 206
Santa Ana, CA 92705-3522

Phone

(714) 453-0688

Fax

(714) 453-0691

NPI assigned

Jul 28, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Geoffrey B. Phillips, M.D.

Title

President

Phone

(714) 453-0688

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• SoCal Behavioral Health Doing business as

Locations

Practitioners 2

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

• Yun Suk Chong, MD

  • Psychiatry Physician
  • Orange, CA
  • NPI 1376586933
  NPD (past)
• Marshall Blake Moncrief, LMFT

  • Marriage & Family Therapist
  • Orange, CA
  • NPI 1912178054
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1528068707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 PARKCENTER DR",
            "address_2": "SUITE 206",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053522",
            "telephone_number": "714-453-0688",
            "fax_number": "714-453-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PARKCENTER DR",
            "address_2": "SUITE 206",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053522",
            "telephone_number": "714-453-0688",
            "fax_number": "714-453-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL BEHAVIORAL HEALTH PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-453-0688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "2780787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "LICENSE # 2780787",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ65665Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoCal Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Marjorie Snyder, RAD-T
• Kacie Nicole Snyder, AC 11485
• Andrew J. So, PA
• Smita Manoj Soans, MD
• Mary Elizabeth C. Sobral, LMFT
• Socal Respiratory Care
• Jiuliana Johanna Sohal
• Solano Chiropractic Incorporated
• Solano Dental & Orthodontics, Inc.
• Solano Dental, Inc.

• Psychiatry Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.