| Oc Progressive Recovery Inc | |
|
1100 W Stewart Dr Er Department Orange CA 92868-3849 | |
| (714) 633-9111 | |
| Not Available |
| Full Name | Oc Progressive Recovery Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1100 W Stewart Dr, Orange, California |
| Authorized Official Name and Position | Ernest Rasyidi (CEO) |
| Authorized Official Contact | 9497151272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oc Progressive Recovery Inc 1 City Blvd W Suite 1100 Orange CA 92868-3621 Ph: (714) 571-5000 | Oc Progressive Recovery Inc 1100 W Stewart Dr Er Department Orange CA 92868-3849 Ph: (714) 633-9111 |
| NPI Number | 1003340217 |
|---|---|
| Provider Enumeration Date | 04/13/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7214207190 |
|---|---|
| Medicare Enrollment ID | O20170726000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003340217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Doris L Asombrado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992778666 PECOS PAC ID: 8628193513 Enrollment ID: I20100915000996 |
| Provider Name | Ashraf Ismail |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720211691 PECOS PAC ID: 2264696749 Enrollment ID: I20120613000324 |
| Provider Name | Ernest Rasyidi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962644997 PECOS PAC ID: 7113182080 Enrollment ID: I20120626000663 |
| Provider Name | Veronica Y Kang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801815998 PECOS PAC ID: 2062667991 Enrollment ID: I20130227000059 |
| Provider Name | Samantha J Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790023281 PECOS PAC ID: 5890929236 Enrollment ID: I20150831000820 |
| Provider Name | Cindy B Illescas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720449358 PECOS PAC ID: 8224335971 Enrollment ID: I20160324001024 |
| Provider Name | Lina Irena Augius |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205026705 PECOS PAC ID: 9133413784 Enrollment ID: I20160804002356 |
| Provider Name | Veronica Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144778200 PECOS PAC ID: 2668750001 Enrollment ID: I20161104001930 |
| Provider Name | Taqialdeen Zamil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598154478 PECOS PAC ID: 8921389099 Enrollment ID: I20170103001574 |
| Provider Name | Shadi Aramesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326487091 PECOS PAC ID: 6305105024 Enrollment ID: I20181114002894 |
| Provider Name | Pamela M Chumpitaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528424173 PECOS PAC ID: 5496088759 Enrollment ID: I20190531001924 |
| Provider Name | Cassandra Silver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508347485 PECOS PAC ID: 6103251525 Enrollment ID: I20200113002331 |
| Provider Name | Narmin Md Aliji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811288822 PECOS PAC ID: 8022448141 Enrollment ID: I20200413003655 |
| Provider Name | Christine Taheran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144642109 PECOS PAC ID: 4486084084 Enrollment ID: I20200422002771 |
| Provider Name | Liezl Gatchalian Talamayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679127518 PECOS PAC ID: 7517375074 Enrollment ID: I20210421002372 |
| Provider Name | Diem-chau L Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891221404 PECOS PAC ID: 5597174409 Enrollment ID: I20210505002678 |
| Provider Name | Goli N Shenasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669933925 PECOS PAC ID: 4183958739 Enrollment ID: I20210518003009 |
| Provider Name | Rohit Sanjeev Aiyer |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1801207014 PECOS PAC ID: 2466787031 Enrollment ID: I20220810003565 |
| Provider Name | Abiodun Toriola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235862780 PECOS PAC ID: 5698158244 Enrollment ID: I20220816000357 |
| Provider Name | Richard Angelo Monforte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487303475 PECOS PAC ID: 5799154183 Enrollment ID: I20221206003270 |
| Provider Name | Mariam Fazil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235827429 PECOS PAC ID: 5597125849 Enrollment ID: I20230718002080 |
| Provider Name | Hieu Dinh Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477263986 PECOS PAC ID: 9830550409 Enrollment ID: I20230728001890 |
| Provider Name | Andrea Yvette Meza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891213914 PECOS PAC ID: 0840651436 Enrollment ID: I20230728002923 |
| Provider Name | Pavel Ksendz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790406882 PECOS PAC ID: 6901268739 Enrollment ID: I20230810003847 |
| Provider Name | Laura Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972283869 PECOS PAC ID: 4183078132 Enrollment ID: I20230926001626 |
| Provider Name | Toni Rose Mallari Dela Paz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588356414 PECOS PAC ID: 4385099530 Enrollment ID: I20231009002459 |
| Provider Name | Andrew Dang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063192953 PECOS PAC ID: 9234584186 Enrollment ID: I20231012000563 |
| Provider Name | Ngoc Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366144180 PECOS PAC ID: 4284080599 Enrollment ID: I20231023002849 |
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