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General NPI Number Information
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NPI Number | 1538015193
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Entity Type | Organization
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Legal Business Name | FORTITUDE MENTAL HEALTH GROUP
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 17011 BEACH BLVD STE 900
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5998
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Country | US
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Telephone | 714-396-9366
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Fax |
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Provider Business Mailing Address
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Address Line | 17011 BEACH BLVD STE 900 PMB 850
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5998
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO / NURSE PRACTITIONER
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Name | NICOLE CHITTUM
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Credential | NP
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Telephone | 714-396-9366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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