Individual provider Active NPI

Brenda Servin

  • Mental Health Counselor
  • Costa Mesa, CA
National Provider Identifier
1558819409
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3540 Howard Way
Suite 150
Costa Mesa, CA 92626-1417
Phone
(949) 646-9227
NPI assigned
Sep 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3540 Howard Way
Suite 150
Costa Mesa, CA 92626-1417

Mailing address

2202 S Greenville St
Santa Ana, CA 92704-4912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Association for Mental Health Mental Health Past Accepting new patients
Orange County Association for Mental Health Mental Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1558819409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 S GREENVILLE ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 HOWARD WAY",
            "address_2": "SUITE 150",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261417",
            "telephone_number": "949-646-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVIN",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_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 Sep 20, 2016; 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.