| Bixby Mental Health Inc. | |
|
600 S San Vicente Blvd Ste 100 Los Angeles CA 90048-4664 | |
| (310) 873-3312 | |
| Not Available |
| Full Name | Bixby Mental Health Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 600 S San Vicente Blvd Ste 100, Los Angeles, California |
| Authorized Official Name and Position | Daniel Ling (CFO) |
| Authorized Official Contact | 3109561123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bixby Mental Health Inc. 9663 Santa Monica Blvd Ste 883 Beverly Hills CA 90210-4303 Ph: (310) 873-3312 | Bixby Mental Health Inc. 600 S San Vicente Blvd Ste 100 Los Angeles CA 90048-4664 Ph: (310) 873-3312 |
| NPI Number | 1932891199 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 05/24/2023 |
| Certification Date | 05/24/2023 |
| Medicare PECOS PAC ID | 4385098458 |
|---|---|
| Medicare Enrollment ID | O20230922001344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932891199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Franklin E Bolanos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215219712 PECOS PAC ID: 8426324161 Enrollment ID: I20171024001722 |
| Provider Name | Kelsey Mcneill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518543990 PECOS PAC ID: 2961819099 Enrollment ID: I20210407001978 |
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