Behavioral Support Partnership

Specialty details in registry · Garden Grove, CA

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At a glance

12443 Lewis St, Garden Grove, CA 92840-4650

NPPES record updated Jul 16, 2015. Public records can lag behind changes at a practice.

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Practice location

12443 Lewis St Suite 201
Garden Grove, CA 92840-4650

Professional details: NPI, taxonomy & registry record

NPI1033593397

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 103K00000X
Enumeration date: Jul 16, 2015
Record updated: Jul 16, 2015

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

103K00000X · Primary

License reported: 1-15-18868 CA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

12443 Lewis St
Suite 201
Garden Grove, CA 92840-4650

Phone: (714) 748-4440

Mailing address

522 WYCLIFFE

IRVINE, CA 926021213

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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