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General NPI Number Information
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NPI Number | 1215734785
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Entity Type | Organization
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Legal Business Name | EAST TO WEST PROFESSIONAL CLINICAL COUNSELOR
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 27201 PUERTA REAL
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City | MISSION VIEJO
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State | CA
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Zip | 92691-7359
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Country | US
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Telephone | 499-665-8989
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Fax |
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Provider Business Mailing Address
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Address Line | 33031 SEAWATCH
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City | DANA POINT
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State | CA
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Zip | 92629-1851
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Country | US
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Telephone | 949-966-5898
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRITTANY NICOLE TAYLOR
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Credential |
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Telephone | 949-966-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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