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CALIFORNIA DIVERSION INTERVENTION FOUNDATION NPI 1154410652


NPI Information

NPI: 1154410652
Provider Name: CALIFORNIA DIVERSION INTERVENTION FOUNDATION
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 05D2253412

Address:
1095 N MAIN ST
SUITE B
ORANGE, CA
ZIP 92867
Phone: (714) 633-0502
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CALIFORNIA DIVERSION INTERVENTION FOUNDATION is an addiction (substance use disorder) counselor in Orange, CA. CALIFORNIA DIVERSION INTERVENTION FOUNDATION NPI is 1154410652. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1095 N MAIN ST
SUITE B
ORANGE, CA
ZIP 92867-476
Phone: (714) 633-0502
Fax: (714) 633-9249

The provider's authorized official is Harry K. Miyaji .
The authorized official title is Program Director and has the following contact phone number (714) 633-0502.

The CLIA number assigned to this NPI record is 05D2253412 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2006 and was last updated on 7/15/2009.


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
1101YA0400XCounselorAddiction (Substance Use Disorder)300125BNCALIFORNIAYes

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
1300125BNOTHERCALIFORNIAOUTPATIENT CERTIFICATION

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: 11/14/2023

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