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 provides Psychiatry Physician services 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