Oceans Edge Wellness Inc

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

OCEANS EDGE WELLNESS INC

Practice address

1420 W 7TH St
San Pedro, CA 90732-3507

Phone

(310) 623-0502

NPI assigned

Oct 17, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Christina Marie Reichert, NURSE PRACTITIONERNPI 1457623969

Title

Executive Director

Phone

(310) 623-0502

Specialties & licenses 6

Addresses

Locations

Practitioners 1

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

• Christina Marie Reichert, NP

  • Family Nurse Practitioner
  • San Pedro, CA
  • NPI 1457623969
  NPD Authorized official

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1942021498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 S ANCHOVY AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907324108",
            "telephone_number": "310-623-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323507",
            "telephone_number": "310-623-0502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1816 S Anchovy Ave",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907324108",
            "country_code": "US",
            "telephone_number": "310-623-0502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1816 S Anchovy Ave",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907324108",
            "country_code": "US",
            "telephone_number": "310-623-0502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OCEANS EDGE WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "REICHERT",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-623-0502",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Marie O'Hurley
• Leigh Ann Oberjuerge
• Michael J Obrien Jr
• Tara Colleen Obrien, PT, DPT
• Ocean Marketing Corp
• Oceanview Living of San Pedro LLC
• Angie Ochoa
• Sharon R Ohara, MFT
• Cole Patrick Olvera, PA
• Opus Medical Center Inc.

• Addiction Medicine (Internal Medicine) Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Addiction Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.