=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972812600
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAMI ORANGE COUNTY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2010
-----------------------------------------------------
Last Update Date | 09/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1810 E 17TH ST
-----------------------------------------------------
City | SANTA ANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92705-8604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-544-8488
-----------------------------------------------------
Fax | 714-544-0791
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1810 E 17TH ST
-----------------------------------------------------
City | SANTA ANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92705-8604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-544-8488
-----------------------------------------------------
Fax | 714-544-0791
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | NANCEE LEE ALLEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-544-8488
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------