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

Dr. Jade Star Fewell, PSYDASSISTANT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1780347237

Dr. Jade Star Fewell, PSYDASSISTANT is an Addiction (Substance Use Disorder) Counselor in Costa Mesa, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

3151 Airway Ave Ste J2
Costa Mesa, CA 92626-4624
Phone: (949) 702-4677
Show map & directions

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

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 94026429 (CA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 15155 (CA)

Record details

NPI number1780347237
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYDASSISTANT
Sole proprietorYes
NPI enumeratedOctober 20, 2021
Last updated in NPPESDecember 26, 2021
Certification dateDecember 26, 2021

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