Equip Health Medical, PC

Primary specialty

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

Legal business name

EQUIP HEALTH MEDICAL, PC

Practice address

2659 State St Ste 100
Carlsbad, CA 92008-1627

Phone

(855) 387-4378

Fax

(760) 683-6585

NPI assigned

Jun 29, 2020

Organization subpart

Yes

Parent organization

EQUIP HEALTH, INC.As reported in NPPES

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

Authorized official

Name

Caitlyn Defiore

Title

Director of Client Operations

Phone

(508) 340-1419

Specialties & licenses 2

Addresses

Electronic endpoints 1

Tax ID family

Equip Health Medical PC2 organizations share this tax ID, including this one

Part of

Equip Health

Other organizations with this tax ID 1

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

• Equip Health Medical, PC

  • Psychiatry Physician
  • Carlsbad, CA
  • NPI 1982466199
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Equip Health

  • Psychiatric/Mental Health Nurse Practitioner
  • La Jolla, CA
  • NPI 1144905852
  NPPES parent name

Practitioners 2

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

• Cara Bohon, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Palo Alto, CA
  • NPI 1831357631
  NPD (past)
• Jennifer Lynn Derenne, MD

  • Child & Adolescent Psychiatry Physician
  • Palo Alto, CA
  • NPI 1285684738
  NPD (past)

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1982221768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131747",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920131747",
            "telephone_number": "619-350-6290",
            "fax_number": "619-436-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 STATE ST STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081627",
            "telephone_number": "855-387-4378",
            "fax_number": "760-683-6585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 NorthWest Bypass",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "59404",
            "country_code": "US",
            "telephone_number": "855-387-4378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1203 N Washington Avenue",
            "address_purpose": "LOCATION",
            "city": "Durant",
            "state": "OK",
            "postal_code": "747012119",
            "country_code": "US",
            "telephone_number": "855-387-4378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9901 Brodie Lane",
            "address_2": "Suite 160, PMB782",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787485892",
            "country_code": "US",
            "telephone_number": "855-387-4378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1781 N Turner St",
            "address_purpose": "LOCATION",
            "city": "Hobbs",
            "state": "NM",
            "postal_code": "882403801",
            "country_code": "US",
            "telephone_number": "855-387-4378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 S La Salle St Ste 814",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606041101",
            "country_code": "US",
            "telephone_number": "855-387-4378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EQUIP HEALTH MEDICAL, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EQUIP HEALTH, INC.",
        "enumeration_date": "2020-06-29",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "DEFIORE",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_title_or_position": "DIRECTOR OF CLIENT OPERATIONS",
        "authorized_official_telephone_number": "508-340-1419"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "api.equipbehavioralhealth.com/api",
            "affiliation": "N",
            "address_1": "2674 Costebelle Dr Unit A",
            "city": "LA Jolla",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920373516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erika England, DPT
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• Sharon Lynn Ereso, PHARM D
• Hasan Suha Ergin, MD
• Erik Huber Counseling Services
• Lynn Noel Erwin, M.A. , MFT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Carlsbad, CA
• Providers in Carlsbad, 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 Dec 12, 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.