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General NPI Number Information
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NPI Number | 1386501401
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Entity Type | Organization
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Legal Business Name | SOUTHA-BUSH NURSING CORP
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1100 W TOWN AND COUNTRY RD STE 1232
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City | ORANGE
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State | CA
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Zip | 92868-4600
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Country | US
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Telephone | 714-817-7447
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Fax | 714-253-3582
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Provider Business Mailing Address
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Address Line | 1100 W TOWN AND COUNTRY RD STE 1232
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City | ORANGE
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State | CA
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Zip | 92868-4600
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Country | US
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Telephone | 714-817-7447
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Fax | 714-253-3582
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DIANA BUSH
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Credential | PMHNP
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Telephone | 714-609-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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