Healthcare Provider Details

I. General information

NPI: 1205368941
Provider Name (Legal Business Name): SENSIBLE CARE, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2677 N MAIN ST STE 110
SANTA ANA CA
92705-6663
US

IV. Provider business mailing address

2677 N MAIN ST STE 130
SANTA ANA CA
92705-6665
US

V. Phone/Fax

Practice location:
  • Phone: 714-274-7577
  • Fax: 714-274-7578
Mailing address:
  • Phone: 714-274-7577
  • Fax: 714-274-7578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL KIM
Title or Position: CEO
Credential:
Phone: 714-274-7573