Kintsugi Health

LBN: Kintsugi Health
Kintsugi Health is an health care organization with primary practice located at 24012 Calle De La Plata Ste 430 , Laguna Hills CA 92653-7623. The organization recently has 12 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Nursing Service Providers / Registered Nurse, Other Service Providers / Acupuncturist, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. Kintsugi Health can be contacted via phone (949) 500-8833, or through Ellison, Tatyana via phone (949) 500-8833.

Contact Information

Primary practice address
24012 Calle De La Plata Ste 430 Laguna Hills CA 92653-7623
Phone: (949) 500-8833
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ellison, Tatyana Doctor of Medicine (MD)
Phone: (949) 500-8833

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Nursing Service Providers / Registered Nurse 163W00000X
Other Service Providers / Acupuncturist 171100000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1730745076
LBN Legal business name Kintsugi Health
DBA Doing business as
Authorized official Ellison, Tatyana Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2019
Last updated May 13th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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