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Organization
RENEWED COMMUNITY MENTAL HEALTH
Active
Organization
RENEWED COMMUNITY MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKSON TEA RN (CFO)
(626) 429-0088
Entity
Organization
Contact information
Practice address
520 N BROOKHURST ST STE 120, ANAHEIM, CA 92801-5233
(714) 333-3559
(714) 333-3559
Mailing address
11278 LOS ALAMITOS BLVD UNIT 905, LOS ALAMITOS, CA 90720-3958
(626) 429-0088
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/29/2024
Last updated
12/10/2024
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