Healthcare Provider Details

I. General information

NPI: 1669398269
Provider Name (Legal Business Name): 2 STEPS AWAY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12791 DALE ST
GARDEN GROVE CA
92841-4521
US

IV. Provider business mailing address

12791 DALE ST
GARDEN GROVE CA
92841-4521
US

V. Phone/Fax

Practice location:
  • Phone: 949-648-7475
  • Fax:
Mailing address:
  • Phone: 949-648-7475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHARLES HARRIS
Title or Position: EXECUTIVE DIRECTOR
Credential: CADC-III
Phone: 949-566-5543