Healthcare Provider Details

I. General information

NPI: 1922145143
Provider Name (Legal Business Name): COUNTY OF ORANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23228 MADERO
MISSION VIEJO CA
92691-2706
US

IV. Provider business mailing address

405 W 5TH ST STE 212
SANTA ANA CA
92701-4522
US

V. Phone/Fax

Practice location:
  • Phone: 949-454-3940
  • Fax: 949-770-1953
Mailing address:
  • Phone: 714-568-5614
  • Fax: 714-834-6595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. CHI Y. RAJALINGAM
Title or Position: CHIEF COMPLIANCE OFFICER
Credential: PH.D., CHC
Phone: 714-834-3154