Healthcare Provider Details

I. General information

NPI: 1972632610
Provider Name (Legal Business Name): ORANGE COUNTY ASSOCIATION FOR MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 HOWARD WAY SUITE 150
COSTA MESA CA
92626-1417
US

IV. Provider business mailing address

1971 E 4TH ST STE 130A
SANTA ANA CA
92705-3917
US

V. Phone/Fax

Practice location:
  • Phone: 949-646-9227
  • Fax: 949-646-9191
Mailing address:
  • Phone: 714-547-7559
  • Fax: 714-640-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY A THRASH
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: MFT
Phone: 714-547-7559