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2001 Wilshire Blvd Ste 302 Santa Monica CA 90403-5685 | |
| (949) 610-2978 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2001 Wilshire Blvd Ste 302, Santa Monica, California |
| Authorized Official Name and Position | Jason Brumback (PRESIDENT) |
| Authorized Official Contact | 5093190845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2900 Bristol St Ste B320 Costa Mesa CA 92626-5987 Ph: (949) 610-2978 | 2001 Wilshire Blvd Ste 302 Santa Monica CA 90403-5685 Ph: (949) 610-2978 |
| NPI Number | 1588333009 |
|---|---|
| Provider Enumeration Date | 09/08/2021 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588333009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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