Amhs Clarvida Anaheim Recovery Center | |
511 N Brookhurst St Ste 200 Anaheim CA 92801-5229 | |
(714) 780-0750 | |
Not Available |
Full Name | Amhs Clarvida Anaheim Recovery Center |
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Speciality | Community/Behavioral Health |
Location | 511 N Brookhurst St Ste 200, Anaheim, California |
Authorized Official Name and Position | Tracy Ginter (DIRECTOR OF STATE OPERATIONS) |
Authorized Official Contact | 6574659497 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Amhs Clarvida Anaheim Recovery Center 8337 Telegraph Rd Ste 300 Pico Rivera CA 90660-4957 Ph: (562) 467-5577 | Amhs Clarvida Anaheim Recovery Center 511 N Brookhurst St Ste 200 Anaheim CA 92801-5229 Ph: (714) 780-0750 |
NPI Number | 1043354624 |
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Provider Enumeration Date | 02/16/2007 |
Last Update Date | 06/20/2024 |
Certification Date | 06/20/2024 |
Medicare PECOS PAC ID | 4183767999 |
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Medicare Enrollment ID | O20100415000405 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043354624 | NPI | - | NPPES |
30CS | Other | CA | MEDI-CAL PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Jairo Gomez |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417055104 PECOS PAC ID: 3173596103 Enrollment ID: I20040817000970 |
Provider Name | Jagdeep Garewal |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427190487 PECOS PAC ID: 2264405075 Enrollment ID: I20040818000929 |
Provider Name | Douglas J Schave |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427263953 PECOS PAC ID: 8426011404 Enrollment ID: I20041110000755 |
Provider Name | Nancy A Metcalf |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1508910076 PECOS PAC ID: 2769567734 Enrollment ID: I20080314000408 |
Provider Name | Connery Lee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124294145 PECOS PAC ID: 6901951615 Enrollment ID: I20090902000140 |
Provider Name | Bruce D Appelbaum |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1528046463 PECOS PAC ID: 6002942679 Enrollment ID: I20100407000653 |
Provider Name | Melinda J Echeverria |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003834367 PECOS PAC ID: 7517145030 Enrollment ID: I20110630000634 |
Provider Name | Chung-lim Kim |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1033361720 PECOS PAC ID: 9032397310 Enrollment ID: I20110711000486 |
Provider Name | Jill A Cavish |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669499588 PECOS PAC ID: 5193996965 Enrollment ID: I20110928000030 |
Provider Name | Joseph P Weigel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063563542 PECOS PAC ID: 1153587324 Enrollment ID: I20120717000239 |
Provider Name | David B Light |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245669134 PECOS PAC ID: 4587893086 Enrollment ID: I20140203001467 |
Provider Name | Berlynn A Ching |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306199906 PECOS PAC ID: 3375768666 Enrollment ID: I20140630000375 |
Provider Name | Blesilda Toohey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588024533 PECOS PAC ID: 3870856495 Enrollment ID: I20180412002903 |
Provider Name | Charlotte Maria Primo Mizuta |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437791381 PECOS PAC ID: 9335579267 Enrollment ID: I20200416003971 |
Provider Name | Timothy Alan Morrisse |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336288430 PECOS PAC ID: 7810328945 Enrollment ID: I20200505002687 |
Provider Name | Dany Jessica Thor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699491860 PECOS PAC ID: 0244684413 Enrollment ID: I20230922000445 |
Provider Name | Maria Del Carmen Bernal |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1003111386 PECOS PAC ID: 0840642070 Enrollment ID: I20240123003708 |
Provider Name | Claudia Ojeda |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1568864064 PECOS PAC ID: 6507209327 Enrollment ID: I20240208003205 |
Provider Name | Jody Ann Vizcay |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1245557974 PECOS PAC ID: 9436594769 Enrollment ID: I20240227001437 |
Provider Name | Nubia Hennessey |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1861676587 PECOS PAC ID: 7719323294 Enrollment ID: I20240306002892 |
Provider Name | Danny Leon Mallory |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1982980272 PECOS PAC ID: 9638518285 Enrollment ID: I20240416003086 |
Provider Name | Eddie Taracena |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1841838554 PECOS PAC ID: 8426498361 Enrollment ID: I20240425003235 |
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