MEDICARE: OCEANS FOR INDIVIDUAL, MARRIAGE AND FAMILY COUNSELING INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1235822347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANS FOR INDIVIDUAL, MARRIAGE AND FAMILY COUNSELING INC.

Provider Business Mailing Address
First Line	:	26791 ALISO CREEK RD # 1097
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-2887
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25283 CABOT RD STE 107
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5509
Country	:	US
Telephone Number	:	949-243-6311
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXANDRA BOZICK
Credential	:	LMFT
Telephone Number	:	949-243-6311

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/04/2023

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