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THE NEW BEGINNING FELLOWSHIP CENTER NPI 1104826072


NPI Information

NPI: 1104826072
Provider Name: THE NEW BEGINNING FELLOWSHIP CENTER
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 05D2166353

Address:
16581 BROOKHURST ST
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (714) 839-2515
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THE NEW BEGINNING FELLOWSHIP CENTER is an addiction (substance use disorder) psychologist in Fountain Valley, CA. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. THE NEW BEGINNING FELLOWSHIP CENTER NPI is 1104826072. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

16581 BROOKHURST ST
FOUNTAIN VALLEY, CA
ZIP 92708-344
Phone: (714) 839-2515
Fax: (714) 839-5501

The provider's authorized official is Alonzo Mitchell .
The authorized official title is Ceo and has the following contact phone number (714) 839-2515.

The CLIA number assigned to this NPI record is 05D2166353 - other - substance abuse with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/21/2005 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)300120ANCALIFORNIANo
2103TA0400XPsychologistAddiction (Substance Use Disorder)300120BNCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1300120ANOTHERCALIFORNIADEPT OF ALCOHOL AND DRUG
2300120BNOTHERCALIFORNIADEPT OF ALCOHOL & DRUG

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

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