| City2village International Initiative | |
|
18726 S Western Ave Ste 403 Gardena CA 90248-3858 | |
| (310) 769-5710 | |
| (844) 850-5892 |
| Full Name | City2village International Initiative |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 18726 S Western Ave Ste 403, Gardena, California |
| Authorized Official Name and Position | Nyiema Desiree' Carter (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3107389271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City2village International Initiative 335 E Albertoni St Ste 200-722 Carson CA 90746-1425 Ph: (310) 738-9271 | City2village International Initiative 18726 S Western Ave Ste 403 Gardena CA 90248-3858 Ph: (310) 769-5710 |
| NPI Number | 1033796669 |
|---|---|
| Provider Enumeration Date | 03/28/2021 |
| Last Update Date | 03/28/2021 |
| Certification Date | 03/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033796669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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