Healthcare Provider Details

I. General information

NPI: 1043187776
Provider Name (Legal Business Name): RCMH, NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2025
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 BALL RD STE 214
CYPRESS CA
90630-3965
US

IV. Provider business mailing address

11278 LOS ALAMITOS BLVD # 905
LOS ALAMITOS CA
90720-3958
US

V. Phone/Fax

Practice location:
  • Phone: 714-333-3559
  • Fax: 714-333-3559
Mailing address:
  • Phone: 714-333-3559
  • Fax: 714-333-3559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JACKSON TEA
Title or Position: CFO/VP
Credential:
Phone: 626-429-0088