Healthcare Provider Details

I. General information

NPI: 1932907664
Provider Name (Legal Business Name): BUTTERFLY EFFECTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18152 WELLINGTON AVE
TUSTIN CA
92780-2245
US

IV. Provider business mailing address

18152 WELLINGTON AVE
TUSTIN CA
92780-2245
US

V. Phone/Fax

Practice location:
  • Phone: 714-296-6452
  • Fax:
Mailing address:
  • Phone: 714-296-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN SILVER
Title or Position: CHIEF FINANCIAL OFFICER
Credential: BACHELOR OF SCIENCE
Phone: 877-500-2186