OCEANS EDGE WELLNESS INC NPI 1942021498

NPI Information

  • NPI: 1942021498
  • Provider Name: OCEANS EDGE WELLNESS INC
  • Classification: Internal Medicine - 207RA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Address: 1420 W 7TH ST
    SAN PEDRO, CA
    ZIP 90732
  • Phone: (310) 623-0502

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NPI Details

OCEANS EDGE WELLNESS INC is an addiction medicine internal medicine in San Pedro, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. OCEANS EDGE WELLNESS INC NPI is 1942021498. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1420 W 7TH ST
SAN PEDRO, CA
ZIP 90732-507
Phone: (310) 623-0502

The provider's authorized official is Christina Marie Reichert .
The authorized official title is Executive Director and has the following contact phone number (310) 623-0502.

The enumeration date for this NPI number is 10/17/2024 and was last updated on 10/17/2024.

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)No
2103TA0400XPsychologistAddiction (Substance Use Disorder)No
3207RA0401XInternal MedicineAddiction MedicineYes
42084P0802XPsychiatry & NeurologyAddiction PsychiatryNo
52084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
6363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

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: 11/21/2025

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