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General NPI Number Information
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NPI Number | 1710452784
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Entity Type | Organization
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Legal Business Name | WE CARE PATH
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 2900 BRISTOL ST
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City | COSTA MESA
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State | CA
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Zip | 92626-5981
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Country | US
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Telephone | 949-283-8394
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SEABLUFF
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-9104
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Country | US
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Telephone | 949-283-8394
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANE EARN EARN
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Credential |
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Telephone | 949-283-8394
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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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