Sean A Jerome, CADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A061540822 Issued in CA

Practice address

1102 Buckingham Dr Apt B
Costa Mesa, CA 92626-2137

Phone

(951) 473-6484

NPI assigned

Apr 7, 2023

Sex

Male

Sole proprietor

Yes

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

• Echo Ridge Wellness

  • Adult Mental Health Clinic/Center
  • Laguna Hills, CA
  • NPI 1831989029

  Addiction (Substance Use Disorder)

  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2023.

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1831884550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 BUCKINGHAM DR APT B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262137",
            "telephone_number": "951-473-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 BUCKINGHAM DR APT B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262137",
            "telephone_number": "951-473-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "A JEROME",
        "first_name": "SEAN",
        "credential": "CADCII",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A061540822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 12 Steps Drug Treatment
• 12925 Hesperia Victorville, Inc.
• 1545 Newport Boulevard LLC
• A Berlowitz Inc
• A Heart for Seniors, Inc.
• A Treasured Heart for Seniors, Inc.
• Shaida Abbas, PHARMD, APP
• Ariana Jiselle Abbott
• Mark Nicholas Abbott, M.A., M.F.T.
• Yasin Osama Abdalla

• All providers in Costa Mesa, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.