| Windstone Behavioral Health | |
|
12377 Lewis St Ste 105 Garden Grove CA 92840-4691 | |
| (866) 388-2810 | |
| (714) 495-3298 |
| Full Name | Windstone Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12377 Lewis St Ste 105, Garden Grove, California |
| Authorized Official Name and Position | Peter James Davidson (CEO) |
| Authorized Official Contact | 7143358406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Windstone Behavioral Health 151 Kalmus Dr Ste K2 Costa Mesa CA 92626-5975 Ph: (866) 388-2810 | Windstone Behavioral Health 12377 Lewis St Ste 105 Garden Grove CA 92840-4691 Ph: (866) 388-2810 |
| NPI Number | 1174607626 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 04/18/2023 |
| Certification Date | 05/03/2022 |
| Medicare PECOS PAC ID | 0547151375 |
|---|---|
| Medicare Enrollment ID | O20040322001724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174607626 | NPI | - | NPPES |
| Provider Name | Said I Jacob |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528128949 PECOS PAC ID: 4183786114 Enrollment ID: I20081229000212 |
| Provider Name | Marla Maciel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952694580 PECOS PAC ID: 1557534849 Enrollment ID: I20111102000155 |
| Provider Name | Laura Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982839239 PECOS PAC ID: 2365600277 Enrollment ID: I20120223000630 |
| Provider Name | Rivy Oseni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306140637 PECOS PAC ID: 5698060044 Enrollment ID: I20160926002052 |
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