Maverick Neurological Healthcare Group, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MAVERICK NEUROLOGICAL HEALTHCARE GROUP, INC.

Practice address

120 Vantis Dr Ste 300
Aliso Viejo, CA 92656-2677

Phone

(949) 216-5185

Fax

(949) 299-2715

NPI assigned

Jul 17, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Sharon Surette Johnson

Title

Chief Executive Officer

Phone

(949) 216-5185

Specialties & licenses 3

Addresses

Other names 1

• NeuroCare Specialty Home Care Doing business as

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

{
    "created_epoch": "1658016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1609501436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 VANTIS DR STE 300",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562677",
            "telephone_number": "949-216-5185",
            "fax_number": "949-299-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VANTIS DR STE 300",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562677",
            "telephone_number": "949-216-5185",
            "fax_number": "949-299-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK NEUROLOGICAL HEALTHCARE GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-17",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "SURETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "949-216-5185",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NeuroCare Specialty Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NeuroCare Specialty Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Dana Martin, MFT
• Felipe Martinez-Ramos
• Joanne Suarez Martinez, D.D.S.,
• Kenneth Patrick Martinez, M.D.
• Matrix Rehabilitation, Inc.
• Jean Michelle Mendiola Mayuga, FNP-C
• Cima Mazar-Atabaki, D.M.D.
• Sara Rosa McCalester, B.A.
• Ruth Ann McCarty, DACM,LAC.
• Jeffry McGhee

• In Home Supportive Care Agency in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.