Healthcare Provider Details

I. General information

NPI: 1346156478
Provider Name (Legal Business Name): PHOENIX HOUSE ORANGE COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 MARINE WAY SUITE 122,124,125
IRVINE CA
92618-2472
US

IV. Provider business mailing address

11600 ELDRIDGE AVE
LAKE VIEW TERRACE CA
91342-6506
US

V. Phone/Fax

Practice location:
  • Phone: 714-953-9373
  • Fax: 714-953-7573
Mailing address:
  • Phone: 818-686-3112
  • Fax: 818-897-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MAJA ANNA TROCHIMCZYK
Title or Position: SENIOR DIRECTOR OF PLANNING AND DEV
Credential: PHD
Phone: 818-686-3112