SAN PEDRO HEALING ARTS MEDICAL CLINIC INC NPI 1538549563

NPI Information

NPI: 1538549563
Provider Name: SAN PEDRO HEALING ARTS MEDICAL CLINIC INC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

CLIA Number: 05D2182912

Address:
22706 ASPAN ST
SUITE 702
LAKE FOREST, CA
ZIP 92630
Phone: (949) 427-1013
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SAN PEDRO HEALING ARTS MEDICAL CLINIC INC is a professional counselor in Lake Forest, CA. SAN PEDRO HEALING ARTS MEDICAL CLINIC INC NPI is 1538549563. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

22706 ASPAN ST
SUITE 702
LAKE FOREST, CA
ZIP 92630-603
Phone: (949) 427-1013

The provider's authorized official is Stephanie Fiamengo .
The authorized official title is Executive Director and has the following contact phone number (310) 547-2197.

The CLIA number assigned to this NPI record is 05D2182912 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/4/2015 and was last updated on 6/4/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	PCCI 1592	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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