| Forward Wellness Family Therapy, Inc. | |
|
1041 E Yorba Linda Blvd Ste 202 Placentia CA 92870-3760 | |
| (800) 701-0937 | |
| Not Available |
| Full Name | Forward Wellness Family Therapy, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1041 E Yorba Linda Blvd Ste 202, Placentia, California |
| Authorized Official Name and Position | Katherine M Wismer (OWNER/PROGRAM DIRECTOR) |
| Authorized Official Contact | 8007010937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forward Wellness Family Therapy, Inc. 1041 E Yorba Linda Blvd Ste 202 Placentia CA 92870-3760 Ph: (800) 701-0937 | Forward Wellness Family Therapy, Inc. 1041 E Yorba Linda Blvd Ste 202 Placentia CA 92870-3760 Ph: (800) 701-0937 |
| NPI Number | 1093398059 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/28/2021 |
| Certification Date | 04/28/2021 |
| Medicare PECOS PAC ID | 9739546144 |
|---|---|
| Medicare Enrollment ID | O20230530002815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093398059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Marc A Campos-ramos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487715785 PECOS PAC ID: 1355489907 Enrollment ID: I20091119000111 |
| Provider Name | Sophia Zafar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740887587 PECOS PAC ID: 5991115024 Enrollment ID: I20201102000250 |
| Provider Name | Shahrezad Chiha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194260083 PECOS PAC ID: 7517366776 Enrollment ID: I20230313002231 |
| Provider Name | Jordyn Dakota Skaggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225510944 PECOS PAC ID: 0042678567 Enrollment ID: I20230615001190 |
| Provider Name | Judy Kao Craig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073711289 PECOS PAC ID: 0749630291 Enrollment ID: I20231222002960 |
| Provider Name | Deenne I Houston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215052014 PECOS PAC ID: 9830549286 Enrollment ID: I20231227001221 |
| Provider Name | Nicole Casella |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174925747 PECOS PAC ID: 0941650097 Enrollment ID: I20240102001975 |
| Provider Name | Denyse E Rehfeld |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770099293 PECOS PAC ID: 7517318512 Enrollment ID: I20240103003655 |
| Provider Name | Aimee Mikalinis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1922493493 PECOS PAC ID: 0941651889 Enrollment ID: I20240104004052 |
| Provider Name | Franklin Clifford Wimberly |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1629691993 PECOS PAC ID: 8527419332 Enrollment ID: I20240105002142 |
| Provider Name | Amy Mandel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770073207 PECOS PAC ID: 2466803135 Enrollment ID: I20240106000245 |
| Provider Name | Katherine M Wismer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245394774 PECOS PAC ID: 3577893650 Enrollment ID: I20240109000233 |
| Provider Name | Traneaka Rashon Turner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1215419601 PECOS PAC ID: 7113378746 Enrollment ID: I20240109000736 |
| Provider Name | Maria Gonzales |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1518019967 PECOS PAC ID: 9830541929 Enrollment ID: I20240112004148 |
| Provider Name | Sandra Palacios Quinonez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437551223 PECOS PAC ID: 2466804794 Enrollment ID: I20240122004413 |
| Provider Name | Carissa Michelle Witham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386134484 PECOS PAC ID: 5698127942 Enrollment ID: I20240123000673 |
| Provider Name | Chandra Kristine Bomben |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144426859 PECOS PAC ID: 5991158636 Enrollment ID: I20240129003286 |
| Provider Name | Ann Michelle Watanabe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437470390 PECOS PAC ID: 7911350210 Enrollment ID: I20240201003660 |
| Provider Name | Leah Josephine Dillon |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144573585 PECOS PAC ID: 6103279443 Enrollment ID: I20240202000158 |
| Provider Name | Merrisa Elizondo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952067803 PECOS PAC ID: 1557704129 Enrollment ID: I20240210000604 |
| Provider Name | Myrna Aguilar Flores |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609172436 PECOS PAC ID: 2062856107 Enrollment ID: I20240216002767 |
| Provider Name | Mitchell N Alvarez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851810816 PECOS PAC ID: 9234573858 Enrollment ID: I20240221004101 |
| Provider Name | Caitlin H Payne |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679174577 PECOS PAC ID: 6103261862 Enrollment ID: I20240304002890 |
| Provider Name | Amy Margaret Childers |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871828038 PECOS PAC ID: 1951749951 Enrollment ID: I20240410001579 |
| Provider Name | Josefina Sarabia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205222411 PECOS PAC ID: 8921447657 Enrollment ID: I20240415002064 |
| Provider Name | Lori Heagerty |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174063556 PECOS PAC ID: 4284073842 Enrollment ID: I20240415003829 |
| Provider Name | Mainkau Kathy Thor |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1427576982 PECOS PAC ID: 4385083542 Enrollment ID: I20240419003082 |
| Provider Name | Michelle Terrazas |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1538798822 PECOS PAC ID: 2466891494 Enrollment ID: I20240423002873 |
| Provider Name | Herbert Burrell Wright |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700368073 PECOS PAC ID: 0446690127 Enrollment ID: I20240429000759 |
| Provider Name | Adriana Rivera |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1518409820 PECOS PAC ID: 9335580646 Enrollment ID: I20240516002486 |
| Provider Name | Michele Bussell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275035172 PECOS PAC ID: 7315388634 Enrollment ID: I20240516003054 |
| Provider Name | Yolanda Jenkins |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912401423 PECOS PAC ID: 9638511819 Enrollment ID: I20240521001174 |
| Provider Name | Monique Nicol Robertson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528479300 PECOS PAC ID: 8325480817 Enrollment ID: I20240529003617 |
| Provider Name | Danielle Mitock |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902228000 PECOS PAC ID: 9537501853 Enrollment ID: I20240531000771 |
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