SO CAL OUTPATIENT NPI 1659750974

NPI Information

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:

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