Healthcare Provider Details

I. General information

NPI: 1427218338
Provider Name (Legal Business Name): UNITED CEREBRAL PALSY OF ORANGE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 E DYER RD STE 150
SANTA ANA CA
92705-5662
US

IV. Provider business mailing address

1251 E DYER RD STE 150
SANTA ANA CA
92705-5662
US

V. Phone/Fax

Practice location:
  • Phone: 949-333-6400
  • Fax: 949-633-6414
Mailing address:
  • Phone: 949-333-6400
  • Fax: 949-633-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RAMIN BASCHSHI
Title or Position: CEO/PRESIDENT
Credential:
Phone: 949-333-6424