So Cal Outpatient

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SO CAL OUTPATIENT

Practice address

17671 Irvine Blvd
Suite 201
Tustin, CA 92780-3178

Phone

(714) 381-0432

NPI assigned

May 19, 2015

Last updated

May 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trina Timanus

Title

Program Manager

Phone

(714) 381-0432

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1659750974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 S CITRON ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054420",
            "telephone_number": "714-381-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17671 IRVINE BLVD",
            "address_2": "SUITE 201",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803178",
            "telephone_number": "714-381-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO CAL OUTPATIENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "TIMANUS",
        "authorized_official_first_name": "TRINA",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "714-381-0432"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Tustin, CA
• Providers in Tustin, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.