Jonathan Ryan Bethel, LCSW # 107684 | |
301 Victoria St, Costa Mesa, CA 92627-7131 | |
(949) 642-2734 | |
Not Available |
Full Name | Jonathan Ryan Bethel |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 301 Victoria St, Costa Mesa, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962087114 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 107684 (California) | Primary |
Entity Name | Fusion Care Group A Psychological Professional Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275177982 PECOS PAC ID: 8921433590 Enrollment ID: O20200109000932 |
Mailing Address | Practice Location Address |
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Jonathan Ryan Bethel, LCSW # 107684 301 Victoria St, Costa Mesa, CA 92627-1995 Ph: (949) 642-2734 | Jonathan Ryan Bethel, LCSW # 107684 301 Victoria St, Costa Mesa, CA 92627-7131 Ph: (949) 642-2734 |
Joseph Madrid, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 252 16th Pl Apt C, Costa Mesa, CA 92627 Phone: 949-566-5222 | |
Shelley Beckham, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 271 Mesa Dr, Costa Mesa, CA 92627 Phone: 949-422-1882 Fax: 949-548-2303 | |
Brian Jacobo, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Jeremy Quang Le, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Lizeth Dimas Sebastian, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2801 Bristol St, Costa Mesa, CA 92626 Phone: 714-850-8408 | |
Kelleen Carrie Stainer, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 555 Anton Blvd Ste 150, Costa Mesa, CA 92626 Phone: 949-204-0011 | |
Grace Tsai, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 940 S Coast Dr Ste 260, Costa Mesa, CA 92626 Phone: 714-907-2318 |