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

Neurodivergent Psychiatric Specialists

Organization Internal Medicine Physician · NPI 1417848219

Neurodivergent Psychiatric Specialists is an Internal Medicine Physician in Santa Ana, California. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
4

Practice location Address checks out

2112 E 4th St Ste 228A
Santa Ana, CA 92705-3840
Phone: (949) 409-6460
Fax: (949) 749-7433
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Psychiatry Physician Taxonomy 2084P0800X
General Practice Physician Taxonomy 208D00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1417848219
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jesse Bonilla — Executive Officer · (714) 420-9890
Other names Neurodivergent Psychiatric Specialists
NPI enumeratedJuly 10, 2025
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025
Mailing address2112 E 4th St Ste 228, Santa Ana, CA 92705-3840

Other providers in Santa Ana