Healthcare Provider Details
I. General information
NPI: 1801520291
Provider Name (Legal Business Name): PEAK MENTAL WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
84 BRIDGEPORT ST
DANA POINT CA
92629-3257
US
IV. Provider business mailing address
84 BRIDGEPORT ST
DANA POINT CA
92629-3257
US
V. Phone/Fax
- Phone: 757-355-3942
- Fax:
- Phone: 757-355-3942
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
HANNAH
DEZZANI
Title or Position: CREDENTIALING MANAGER
Credential: MFT
Phone: 757-355-7181