Avid Mental Health a Professional Nursing Corporation

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

AVID MENTAL HEALTH A PROFESSIONAL NURSING CORPORATION

Practice address

1820 W Orangewood Ave Ste 104
Orange, CA 92868-5051

Phone

(714) 461-4121

NPI assigned

Mar 27, 2024

Organization subpart

No

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

Authorized official

Name

Jessica JunNPI 1265951016

Title

Coo

Phone

(714) 461-4121

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Jessica Jun, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendora, CA
  • NPI 1265951016
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1700637956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 N TUSTIN ST # 1036",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928653902",
            "telephone_number": "714-461-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 W ORANGEWOOD AVE STE 104",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685051",
            "telephone_number": "714-461-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVID MENTAL HEALTH A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "JUN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "714-461-4121"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syerra Lanie Avalos
• Avani Sarvaiya DDS Inc
• Avery Home Health Agency, Inc.
• Andrea D. Avery, MD
• Gabrielle Maria Avery, MD, MPH
• Yvette M Avila-Cao, RN
• Alexandra Isabel Avila
• Alexia Artzelynn Avila
• David A Avila
• Edwin Daniel Avila

• Psychiatric/Mental Health Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.