Provider Demographics
NPI:1396201273
Name:CENTER FOR INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:CENTER FOR INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL AND RESEARCH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PANIAGUA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-945-9120
Mailing Address - Street 1:23 CORPORATE PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7908
Mailing Address - Country:US
Mailing Address - Phone:949-945-9120
Mailing Address - Fax:
Practice Address - Street 1:23 CORPORATE PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7908
Practice Address - Country:US
Practice Address - Phone:949-945-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty