Healthcare Provider Details

I. General information

NPI: 1356035513
Provider Name (Legal Business Name): MISSION PREP HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SUNNYFIELD DR
ROLLING HILLS ESTATES CA
90274-2504
US

IV. Provider business mailing address

30310 RANCHO VIEJO RD
SAN JUAN CAPISTRANO CA
92675-1576
US

V. Phone/Fax

Practice location:
  • Phone: 833-589-5150
  • Fax: 949-579-2876
Mailing address:
  • Phone:
  • Fax: 949-579-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY FARBMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 949-301-2863