Neurodivergent Psychiatric Specialists
NPI 1417848219 · Internal Medicine Physician · Santa Ana, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Neurodivergent Psychiatric Specialists is a Internal Medicine Physician organization in Santa Ana, CA (NPI 1417848219).
Provider details
- NPI number
- 1417848219
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jesse Bonilla, Executive Officer(714) 420-9890
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Physician Assistants & Advanced Practice Nursing Providers
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Neurodivergent Psychiatric Specialists
Registry dates
- Enumerated
- 2025-07-10
- Last updated
- 2025-12-08
- Certified
- 2025-12-08
Frequently asked questions
- What is Neurodivergent Psychiatric Specialists's NPI number?
- Neurodivergent Psychiatric Specialists's National Provider Identifier (NPI) is 1417848219, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Neurodivergent Psychiatric Specialists?
- Neurodivergent Psychiatric Specialists is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Neurodivergent Psychiatric Specialists located?
- Neurodivergent Psychiatric Specialists's practice location on file with NPPES is 2112 E 4th St, Santa Ana, CA 92705-3840.
- What is Neurodivergent Psychiatric Specialists's phone number?
- The practice phone number listed in the NPPES registry for Neurodivergent Psychiatric Specialists is (949) 409-6460.
- Does Neurodivergent Psychiatric Specialists accept Medicare?
- Neurodivergent Psychiatric Specialists is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Neurodivergent Psychiatric Specialists?
- The authorized official listed on Neurodivergent Psychiatric Specialists's NPPES record is Jesse Bonilla, Executive Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Neurodivergent Psychiatric Specialists's NPI active?
- Yes — Neurodivergent Psychiatric Specialists's NPI (1417848219) is active in the NPPES registry as of the last update on 2025-12-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.