Provider Demographics
NPI:1013138486
Name:BIRTHCHOICE HEALTH CLINIC
Entity Type:Organization
Organization Name:BIRTHCHOICE HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JESSELYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-836-5447
Mailing Address - Street 1:415 N SYCAMORE ST
Mailing Address - Street 2:ST. 200
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4607
Mailing Address - Country:US
Mailing Address - Phone:714-836-5447
Mailing Address - Fax:714-836-1855
Practice Address - Street 1:415 N SYCAMORE ST
Practice Address - Street 2:ST. 200
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4607
Practice Address - Country:US
Practice Address - Phone:714-836-5447
Practice Address - Fax:714-836-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health