| Emotional Change Inc. | |
|
4368 Eagle Rock Blvd Los Angeles CA 90041-3211 | |
| (314) 974-7347 | |
| (314) 843-0201 |
| Full Name | Emotional Change Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 4368 Eagle Rock Blvd, Los Angeles, California |
| Authorized Official Name and Position | Kimberly George (CEO) |
| Authorized Official Contact | 3149747347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional Change Inc. 4368 Eagle Rock Blvd Los Angeles CA 90041-3211 Ph: (314) 974-7347 | Emotional Change Inc. 4368 Eagle Rock Blvd Los Angeles CA 90041-3211 Ph: (314) 974-7347 |
| NPI Number | 1861753337 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 05/31/2012 |
| Medicare PECOS PAC ID | 7315198959 |
|---|---|
| Medicare Enrollment ID | O20121108000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861753337 | NPI | - | NPPES |
| Provider Name | Rebecca Ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548746423 PECOS PAC ID: 3173971777 Enrollment ID: I20231120002977 |
| Provider Name | Crystin Roufaeil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437630357 PECOS PAC ID: 3779935903 Enrollment ID: I20240123003656 |
| Provider Name | Ahila Muthaiya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417713983 PECOS PAC ID: 3577901669 Enrollment ID: I20240409002544 |
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