Peak State Wellness a Jared Young DC Corporation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PEAK STATE WELLNESS A JARED YOUNG DC CORPORATION

Practice address

8780 Warner Ave Ste 11
Fountain Valley, CA 92708-3210

Phone

(714) 847-8989

Fax

(714) 333-4193

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Jared Young, DC

Title

Owner

Phone

(714) 847-8989

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1831767987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8780 WARNER AVE STE 11",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083210",
            "telephone_number": "714-847-8989",
            "fax_number": "714-333-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8780 WARNER AVE STE 11",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083210",
            "telephone_number": "714-847-8989",
            "fax_number": "714-333-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK STATE WELLNESS A JARED YOUNG DC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-847-8989",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.