Individual provider Active NPI

Samantha Perkins

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1790023281
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2265878 Issued in CA
Practice address
1417 S Parton St
Santa Ana, CA 92707-1629
Phone
(952) 212-4353
NPI assigned
Jan 18, 2013
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2265848 MA
Adult Health Nurse Practitioner 363LA2200X RN2265878 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2265878 CA Primary

Addresses

Primary practice location

1417 S Parton St
Santa Ana, CA 92707-1629

Mailing address

1417 S Parton St
Santa Ana, CA 92707-1629
Phone (952) 212-4353

Other practice location 1

21416 Lake Forest Dr
Apt F
Lake Forest, CA 92630-6044
Phone (857) 654-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831000820 CA Practitioner - Nurse Practitioner 5890929236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oc Progressive Recovery Inc.Group PAC ID 7214207190, 21 clinicians
Nebula Health, LLCGroup PAC ID 8820482805, 17 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

23228 Madero
Mission Viejo, CA 92691-2706
Phone (949) 900-4580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2265848MAMDRegistered Nurse
RN2265878MAMDAdult Health Nurse Practitioner
RN2265878CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebula Health, LLC CurrentSince Apr 17, 2024 Accepting new patients
Oc Progressive Recovery Inc CurrentSince Sep 2, 2019 Accepting new patients
Etc Consultants Inc CurrentSince Jan 19, 2023 Accepting new patients

Locations

3350 W Ball Rd
Anaheim, CA 92804
Phone (714) 220-4533

875 N Brea Blvd
Brea, CA 92821
Phone (714) 529-6842

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

6000 Camino Real
Riverside, CA 92509
Phone (951) 360-0000

5900 Brockton Ave
Riverside, CA 92506
Phone (800) 992-0901

6833 Indiana Ave
Ste 101
Riverside, CA 92506
Phone (657) 346-6319

806 Avenida Pico
#I330
San Clemente, CA 92673

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1790023281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S PARTON ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927071629",
            "telephone_number": "952-212-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S PARTON ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927071629",
            "telephone_number": "952-212-4353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21416 Lake Forest Dr",
            "address_2": "Apt F",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926306044",
            "country_code": "US",
            "telephone_number": "857-654-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-18",
        "last_updated": "2022-11-22",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2265848",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2265878",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "RN2265878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.