| Shanti Orange County | |
|
23461 S Pointe Dr Suite 100 Laguna Hills CA 92653-1547 | |
| (949) 452-0888 | |
| Not Available |
| Full Name | Shanti Orange County |
|---|---|
| Speciality | Clinic/Center |
| Location | 23461 S Pointe Dr, Laguna Hills, California |
| Authorized Official Name and Position | Lindsay Fitzpatrick (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9494520888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanti Orange County 23461 S Pointe Dr Suite 100 Laguna Hills CA 92653-1547 Ph: (949) 452-0888 | Shanti Orange County 23461 S Pointe Dr Suite 100 Laguna Hills CA 92653-1547 Ph: (949) 452-0888 |
| NPI Number | 1447656418 |
|---|---|
| Provider Enumeration Date | 11/18/2014 |
| Last Update Date | 12/21/2023 |
| Certification Date | 12/21/2023 |
| Medicare PECOS PAC ID | 9537475736 |
|---|---|
| Medicare Enrollment ID | O20150903002619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447656418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lindsay Ann Brackman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689071573 PECOS PAC ID: 1850697178 Enrollment ID: I20160314001060 |
| Provider Name | Dana Faulkner Hodgdon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417351388 PECOS PAC ID: 1951675503 Enrollment ID: I20170920000936 |
| Provider Name | Nina Tilka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730716564 PECOS PAC ID: 3779913371 Enrollment ID: I20200422002689 |
| Provider Name | Michelle S Olea |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1962018085 PECOS PAC ID: 3577908268 Enrollment ID: I20240304004085 |
| Provider Name | Adam Joseph Browning |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497494538 PECOS PAC ID: 1658718291 Enrollment ID: I20240319002048 |
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