Healthcare Provider Details

I. General information

NPI: 1811800790
Provider Name (Legal Business Name): ADI GOREN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 AVOCADO AVE STE 306
NEWPORT BEACH CA
92660-7704
US

IV. Provider business mailing address

18765 CALERA LN
HUNTINGTON BEACH CA
92648-6828
US

V. Phone/Fax

Practice location:
  • Phone: 949-644-8556
  • Fax:
Mailing address:
  • Phone: 949-644-8556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: