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NEURODIVERGENT PSYCHIATRIC SPECIALISTS
NPI 1417848219
Internal Medicine in Santa Ana, CA

Active since July 10, 2025
2112 E 4TH ST, STE 228A, SANTA ANA, CA 92705(949) 409-6460(949) 749-7433 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 8, 2025, Oct 9, 2025, Sep 18, 2025 and 2 more (5 updates tracked since 2025).

About Neurodivergent Psychiatric Specialists NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEURODIVERGENT PSYCHIATRIC SPECIALISTS (NPI 1417848219) is a healthcare organization registered as an internal medicine in Santa Ana, California and active in the NPI registry since July 2025. The organization lists Jesse Anthony Bonilla, Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1417848219
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameNEURODIVERGENT PSYCHIATRIC SPECIALISTS
Location Address2112 E 4TH ST, STE 228ASanta Ana, CA 92705-3840
Mailing Address2112 E 4th St Ste 228Santa Ana, CA 92705-3840 · (949) 409-6460 · Fax (949) 749-7433
Phone(949) 409-6460
Fax(949) 749-7433
Organization SubpartNo
Authorized OfficialJesse Anthony BonillaExecutive Officer · (714) 420-9890
Enumeration DateJuly 10, 2025
Last NPPES UpdateDecember 8, 20255 updates tracked since enumeration
NPPES CertifiedDecember 8, 2025
✔ NPI 1417848219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
2112 E 4TH ST, Santa Ana, CA 92705
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Other Names 1

Doing Business AsNeurodivergent Psychiatric Specialists

Other Identifiers 1

MedicaidCB540002CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORRI M. WHITNEY D.C.
Chiropractor
2112 E 4TH ST, SUITE 220
SANTA ANA, CA 92705
Orange County (714) 835-9080
ELIZABETH ESCOBAR
Counselor
2112 E 4TH ST, STE. 107
SANTA ANA, CA 92705
Orange County (714) 399-1860
CASSANDRA LARA
Social Worker (Clinical)
2112 E 4TH ST
SANTA ANA, CA 92705
Orange County (714) 399-1860
MRS. PILAR CATHERINE CHAVEZ
Counselor
2112 E 4TH ST, #107
SANTA ANA, CA 92705
Orange County (714) 399-1860
MISS JESSICA SANCHEZ
Social Worker
2112 E 4TH ST
SANTA ANA, CA 92705
Orange County (714) 399-1860
ASSURANCE HOSPICE SOUTH COAST, INC.
Hospice Care, Community Based
2112 E 4TH ST, SUITE 228
SANTA ANA, CA 92705
Orange County (714) 550-6081
WESTWOOD OPEN MRI, LLC
Radiology (Neuroradiology)
2112 E 4TH ST, SUITE 220
SANTA ANA, CA 92705
Orange County (714) 835-9080
ELECTRONIC ORTHOPEDIC IMAGING MEDICAL ASSOCIATES, INC
Radiology (Diagnostic Radiology)
2112 E 4TH ST, SUITE 220
SANTA ANA, CA 92705
Orange County (714) 835-9080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Neurodivergent Psychiatric Specialists's NPI number?

The NPI number for Neurodivergent Psychiatric Specialists is 1417848219. It was assigned to this organization in the NPPES registry on July 10, 2025.

Where is Neurodivergent Psychiatric Specialists located?

Neurodivergent Psychiatric Specialists is located at 2112 E 4th St Ste 228A, Santa Ana, CA 92705. The listed phone number is (949) 409-6460.

What is Neurodivergent Psychiatric Specialists's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Neurodivergent Psychiatric Specialists was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.