Eating Disorder Center of California

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EATING DISORDER CENTER OF CALIFORNIA

Doing business as

Eating Disorder Center of Newport Beach

Practice address

2 Corporate Plaza Dr
Suite 200
Newport Beach, CA 92660-7929

Phone

(305) 663-1876

Fax

(786) 359-4485

NPI assigned

Aug 26, 2016

Last updated

Aug 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mike Bagley

Title

Chief Financial Officer

Phone

(305) 663-1876

Specialties & licenses 1

Addresses

Other names 1

• Eating Disorder Center of Newport Beach Doing business as

Tax ID family

Brentwood - Eating Disorder Center of California LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brentwood - Eating Disorder Center of California, LLC

  dba Eating Disorder Center of California

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1730537754
  NPD tax ID

Locations

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1952857336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 76TH STREET",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "305-663-1876",
            "fax_number": "786-359-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORPORATE PLAZA DR",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607929",
            "telephone_number": "305-663-1876",
            "fax_number": "786-359-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EATING DISORDER CENTER OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-26",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "BAGLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-663-1876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eating Disorder Center of Newport Beach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eating Disorder Center of Newport Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mary Carlyn Eberhart, D.C.
• Cindy Echeverria
• Emily Echeverria, MS, LMFT
• Edelweiss Individual and Family Therapy
• Eden Fertility Center of Newport Beach (Eden Centers for Advanced Fertility)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.