SO CAL OUTPATIENT NPI 1659750974

NPI Information

  • NPI: 1659750974
  • Provider Name: SO CAL OUTPATIENT
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 17671 IRVINE BLVD
    SUITE 201
    TUSTIN, CA
    ZIP 92780
  • Phone: (714) 381-0432

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NPI Details

SO CAL OUTPATIENT is an addiction (substance use disorder) counselor in Tustin, CA. SO CAL OUTPATIENT NPI is 1659750974. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17671 IRVINE BLVD
SUITE 201
TUSTIN, CA
ZIP 92780-178
Phone: (714) 381-0432

The provider's authorized official is Trina Timanus .
The authorized official title is Program Manager and has the following contact phone number (714) 381-0432.

The enumeration date for this NPI number is 5/19/2015 and was last updated on 5/19/2015.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)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: 3/30/2025

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