Healthcare Provider Details

I. General information

NPI: 1538868138
Provider Name (Legal Business Name): NEW CHOICES OUTPATIENT FOR ALL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5612 BOOT WAY
OCEANSIDE CA
92057-4809
US

IV. Provider business mailing address

5612 BOOT WAY
OCEANSIDE CA
92057-4809
US

V. Phone/Fax

Practice location:
  • Phone: 442-500-4594
  • Fax: 844-710-7865
Mailing address:
  • Phone: 442-500-4594
  • Fax: 844-710-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LANEISCHA CHSETER
Title or Position: OWNER
Credential:
Phone: 442-500-4594