Socal Adolescent Wellness, Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

SOCAL ADOLESCENT WELLNESS, INC.

Practice address

22471 Aspan St Ste 110
Lake Forest, CA 92630-1644

Phone

(714) 465-2305

NPI assigned

Oct 25, 2023

Organization subpart

No

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

Authorized official

Name

Rebecca M Harris

Title

Cfo

Phone

(949) 467-4324

Specialties & licenses 1

Addresses

Tax ID family

Socal Adolescent Wellness Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Socal Adolescent Wellness, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Huntington Beach, CA
  • NPI 1023598299
  NPD tax ID
• Socal Adolescent Wellness, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Lake Forest, CA
  • NPI 1083230262
  NPD tax ID
• Socal Adolescent Wellness, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Huntington Beach, CA
  • NPI 1619551124
  NPD tax ID

Locations

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1972375715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16168 BEACH BLVD STE 170",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22471 ASPAN ST STE 110",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301644",
            "telephone_number": "714-465-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL ADOLESCENT WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-467-4324"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sky Wellness Center Inc
• Michelle Gonzales Slade
• Smith Home Care Inc.
• Chelsi Joy Smith I, CNA
• Socal Adolescent Wellness, Inc.
• Socal Counseling Services
• Socal Empowered, LLC
• Sofia Rodriguez DDS, Inc.
• Mariam Soldin-Wasfi, D.M.D
• Amani Soliman, D.D.S.

• Adolescent and Children Mental Health Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.