Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blooming Integrative Psychiatry

Organization Psychiatry Physician · NPI 1417812587

Blooming Integrative Psychiatry is a Psychiatry Physician in Canyon Lake, California. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

23283 Canyon Lake Dr S
Canyon Lake, CA 92587-7598
Phone: (951) 387-0782
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1417812587
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hannah Fraley — Ceo · (951) 387-0782
NPI enumeratedDecember 19, 2025
Last updated in NPPESDecember 19, 2025
Certification dateDecember 19, 2025
Mailing address31566 Railroad Canyon Rd Ste 2, Canyon Lake, CA 92587-9446