Individual provider Active NPI

D Dawn Maxwell, M.A. CATC IV

  • Addiction (Substance Use Disorder) Counselor
  • San Juan Capistrano, CA
National Provider Identifier
1679091441
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
168115IV Issued in CA
Practice address
30950 Rancho Viejo Rd Suite 225
San Juan Capistrano, CA 92675
Phone
(949) 701-1134
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 168115IV CA Primary

Addresses

Primary practice location

30950 Rancho Viejo Rd Suite 225
San Juan Capistrano, CA 92675

Mailing address

27758 Santa Margarita Pkwy # 554
Mission Viejo, CA 92691-6709
Phone (949) 701-1134

Other identifiers 1

IdentifierTypeStateIssuer
168115IVOtherCAACCBC (CAADE)

Other names 1

  • D. Dawn Maxwell Other name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
168115IVCAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679091441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27758 SANTA MARGARITA PKWY # 554",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916709",
            "telephone_number": "949-701-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30950 RANCHO VIEJO RD SUITE 225",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "92675",
            "telephone_number": "949-701-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "D",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "M.A. CATC IV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "168115IV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCBC (CAADE)",
            "identifier": "168115IV",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D. DAWN",
            "last_name": "MAXWELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.