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Organization
DIVERSIFIED BEHAVIORAL HEALTH, A PROFESSIONAL CLINICAL COUNSELOR CORPO
Active
Organization
DIVERSIFIED BEHAVIORAL HEALTH, A PROFESSIONAL CLINICAL COUNSELOR CORPO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY BORING-BRAY (PRESIDENT)
(949) 842-8595
Entity
Organization
Contact information
Practice address
26040 ACERO STE 207, MISSION VIEJO, CA 92691-2768
(949) 842-8595
Mailing address
PO BOX 224, DANA POINT, CA 92629-0224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699028134
NPPES
—
Enumeration date
10/26/2020
Last updated
11/13/2020
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