Organization · Type 2 NPI
San Diego Professional Group, P. C.
Addiction Medicine (Psychiatry & Neurology) Physician · Aliso Viejo, CA
Practice location
24552 Pacific Park Dr
Aliso Viejo, CA 92656-3033
Fax (615) 457-8094
Mailing address
200 Powell Pl, Attn: Legal Department
Brentwood, TN 37027-7514
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 20A6119 (CA) |
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 20A6119 (CA) |
| Addiction Medicine (Psychiatry & Neurology) Physician Primary | 2084A0401X | 20A6119 (CA) |
Addiction Medicine (Psychiatry & Neurology) Physician: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
10 other providers at this address
- Hans-On Recovery, PLLCAddiction Medicine (Internal Medicine) Physician Aliso Viejo, CA NPI 1225796337
- Laguna Treatment Hospital, LLCSpecial Hospital Aliso Viejo, CA NPI 1063860534
- Prism Health Inc.Assisted Living Facility Aliso Viejo, CA NPI 1417108085
- Ashley Yusam, PA-CPhysician Assistant Aliso Viejo, CA NPI 1275986077
- Christopher Cummins, LMFT, LCADC, ACSMarriage & Family Therapist Aliso Viejo, CA NPI 1639415490
- Evaggelos Gary Mitrevolis, MDAddiction Medicine (Preventive Medicine) Physician Aliso Viejo, CA NPI 1154632990
- Holly Ann Olalia, DNP, PMHNPPsychiatric/Mental Health Nurse Practitioner Aliso Viejo, CA NPI 1538751409
- Laquicha Westervelt, FNP-C, PMHNP-BCFamily Nurse Practitioner Aliso Viejo, CA NPI 1992166912
- Lilian Rose Ballentos Gumban-Saldana, NPPsychiatric/Mental Health Nurse Practitioner Aliso Viejo, CA NPI 1124993290
- Yen Anker, NPNurse Practitioner Aliso Viejo, CA NPI 1104273309
About NPI 1699220004
San Diego Professional Group, P. C.'s National Provider Identifier is 1699220004, issued on Aug 16, 2016. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in Aliso Viejo, CA. The record was last updated on Aug 25, 2021.