| Conscious Culture Psychology Clinic Inc. | |
|
5800 S Eastern Ave Commerce CA 90040-4016 | |
| (626) 430-4521 | |
| (626) 498-1483 |
| Full Name | Conscious Culture Psychology Clinic Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5800 S Eastern Ave, Commerce, California |
| Authorized Official Name and Position | Anita Louise Mihecoby (CEO) |
| Authorized Official Contact | 6266584297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conscious Culture Psychology Clinic Inc. 5800 S Eastern Ave Ste 500 Commerce CA 90040-4033 Ph: (626) 658-4297 | Conscious Culture Psychology Clinic Inc. 5800 S Eastern Ave Commerce CA 90040-4016 Ph: (626) 430-4521 |
| NPI Number | 1033690235 |
|---|---|
| Provider Enumeration Date | 08/24/2018 |
| Last Update Date | 02/02/2023 |
| Certification Date | 02/02/2023 |
| Medicare PECOS PAC ID | 0345636734 |
|---|---|
| Medicare Enrollment ID | O20221129001368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033690235 | NPI | - | NPPES |
| IN249Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | 29218 (California) | Primary |
| Provider Name | Anita Louise Mihecoby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588099766 PECOS PAC ID: 7315245933 Enrollment ID: I20200622000284 |
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