MEDICARE: PEAK MENTAL WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1801520291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK MENTAL WELLNESS

Provider Business Mailing Address
First Line	:	84 BRIDGEPORT ST
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-3257
Country	:	US
Telephone Number	:	757-355-3942
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 BRIDGEPORT ST
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-3257
Country	:	US
Telephone Number	:	757-355-3942
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MS. HANNAH DEZZANI
Credential	:	MFT
Telephone Number	:	757-355-7181

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	06/11/2026

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Directions to “PEAK MENTAL WELLNESS ” Practice Location

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