| Enki - Boyle Heights Adult | |
|
560 S St Louis St Los Angeles CA 90033-4320 | |
| (213) 480-1557 | |
| (213) 480-1182 |
| Full Name | Enki - Boyle Heights Adult |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 560 S St Louis St, Los Angeles, California |
| Authorized Official Name and Position | Darren Takemoto (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8189734899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enki - Boyle Heights Adult 150 E Olive Ave #203 Burbank CA 91502-1846 Ph: (818) 973-4899 | Enki - Boyle Heights Adult 560 S St Louis St Los Angeles CA 90033-4320 Ph: (213) 480-1557 |
| NPI Number | 1932230638 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Medicare PECOS PAC ID | 8022926559 |
|---|---|
| Medicare Enrollment ID | O20040117000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932230638 | NPI | - | NPPES |
| 000007255 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Yatin Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508999855 PECOS PAC ID: 7517868946 Enrollment ID: I20040117000209 |
| Provider Name | Cecilia L Hsia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437289246 PECOS PAC ID: 8921091323 Enrollment ID: I20040402001480 |
| Provider Name | Adnan E Khoury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023101888 PECOS PAC ID: 5597754853 Enrollment ID: I20040511000867 |
| Provider Name | Maria Lucila Sison Llanes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235181454 PECOS PAC ID: 4284665266 Enrollment ID: I20050830000284 |
| Provider Name | Edward B Nino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053486944 PECOS PAC ID: 7214969005 Enrollment ID: I20050831000912 |
| Provider Name | Armen Azatian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578670964 PECOS PAC ID: 1658390455 Enrollment ID: I20051121000901 |
| Provider Name | Percival J Baldrias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831399740 PECOS PAC ID: 8628163599 Enrollment ID: I20071008000176 |
| Provider Name | Mark T Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306919584 PECOS PAC ID: 8224128145 Enrollment ID: I20071215000262 |
| Provider Name | Wagih A Elsewafy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679604235 PECOS PAC ID: 8224107594 Enrollment ID: I20080513000644 |
| Provider Name | Victor L Cheang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528240926 PECOS PAC ID: 6901977362 Enrollment ID: I20080612000749 |
| Provider Name | Joyce T Cudanes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558490888 PECOS PAC ID: 6103999636 Enrollment ID: I20080716000863 |
| Provider Name | Lillian Morales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619010683 PECOS PAC ID: 3870401912 Enrollment ID: I20091221000660 |
| Provider Name | Michael P Zelman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104969187 PECOS PAC ID: 6204976244 Enrollment ID: I20091222000663 |
| Provider Name | Jennifer A Oday |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760545693 PECOS PAC ID: 4486781960 Enrollment ID: I20100415000497 |
| Provider Name | Lian P Chien |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124105721 PECOS PAC ID: 4587794540 Enrollment ID: I20100617000633 |
| Provider Name | Jorge Trujillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801978374 PECOS PAC ID: 2264629757 Enrollment ID: I20101209000795 |
| Provider Name | Esther Ishitani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275677585 PECOS PAC ID: 7012198773 Enrollment ID: I20110301000268 |
| Provider Name | Pranav J Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497905749 PECOS PAC ID: 5496936056 Enrollment ID: I20110302000353 |
| Provider Name | Shohreh Ghaemian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871615591 PECOS PAC ID: 5698957058 Enrollment ID: I20110308000008 |
| Provider Name | Maria P Aguilar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508955824 PECOS PAC ID: 8224212279 Enrollment ID: I20110415000283 |
| Provider Name | Barbara J Saunders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144365149 PECOS PAC ID: 6305023037 Enrollment ID: I20110607000351 |
| Provider Name | Jungyeol Oh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447414552 PECOS PAC ID: 8527124155 Enrollment ID: I20120112000567 |
| Provider Name | Donald J Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629278304 PECOS PAC ID: 7618102328 Enrollment ID: I20131106000298 |
| Provider Name | Heather J Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174657902 PECOS PAC ID: 3971733460 Enrollment ID: I20140228001943 |
| Provider Name | Anshu Agarwal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578715181 PECOS PAC ID: 7214153246 Enrollment ID: I20140728000689 |
| Provider Name | Alma Carrasquillo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982733747 PECOS PAC ID: 3375760440 Enrollment ID: I20140813001694 |
| Provider Name | Bridget Kathleen Cleary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053691790 PECOS PAC ID: 4082832753 Enrollment ID: I20140822000761 |
| Provider Name | Brandon Phillip Uribe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215360037 PECOS PAC ID: 4486970357 Enrollment ID: I20150312000297 |
| Provider Name | Brenda Tabone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073949863 PECOS PAC ID: 4587981618 Enrollment ID: I20150328000194 |
| Provider Name | Edward Lei |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538536230 PECOS PAC ID: 1052628286 Enrollment ID: I20150921000316 |
| Provider Name | Sean Rougeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558506865 PECOS PAC ID: 6406148543 Enrollment ID: I20160709000033 |
| Provider Name | Marina Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134552953 PECOS PAC ID: 0244525327 Enrollment ID: I20160829001762 |
| Provider Name | Patricia Carlos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710173745 PECOS PAC ID: 2668752130 Enrollment ID: I20161130000273 |
| Provider Name | Maral Vahe Derkhorenian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336693019 PECOS PAC ID: 2860772878 Enrollment ID: I20161209000123 |
| Provider Name | Diana Tabatha Mendez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073884920 PECOS PAC ID: 2769767722 Enrollment ID: I20170314001982 |
| Provider Name | Vanessa Jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780991059 PECOS PAC ID: 9335425875 Enrollment ID: I20170417001224 |
| Provider Name | Taryn Jean Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275990699 PECOS PAC ID: 2860766458 Enrollment ID: I20170920002710 |
| Provider Name | Janet Lynn Blawn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285905182 PECOS PAC ID: 0345509600 Enrollment ID: I20180111001147 |
| Provider Name | Skyler S Galindo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730446808 PECOS PAC ID: 5597045393 Enrollment ID: I20180420001040 |
| Provider Name | Jodon English |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861873796 PECOS PAC ID: 4486909595 Enrollment ID: I20180613001996 |
| Provider Name | Leopoldo Velasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326112194 PECOS PAC ID: 7416290945 Enrollment ID: I20190523001785 |
| Provider Name | Liliana Patricia Londono |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548330400 PECOS PAC ID: 9335472190 Enrollment ID: I20190610002307 |
| Provider Name | Kelly Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851844880 PECOS PAC ID: 1557690252 Enrollment ID: I20190905001417 |
| Provider Name | Tiffany Lynn Arroyo-mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831448646 PECOS PAC ID: 0345676854 Enrollment ID: I20200131001557 |
| Provider Name | Liezl Gatchalian Talamayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679127518 PECOS PAC ID: 7517375074 Enrollment ID: I20210421002372 |
| Provider Name | Diana Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376176487 PECOS PAC ID: 4981004751 Enrollment ID: I20210616000328 |
| Provider Name | Aida Stephanie Rivas |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1518337849 PECOS PAC ID: 8325486426 Enrollment ID: I20240409002769 |
| Provider Name | Darren Francis Goldstein |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952428088 PECOS PAC ID: 1850732579 Enrollment ID: I20240513002617 |
Emq Hollygrove Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 N El Centro Ave, Los Angeles, CA 90038 Phone: 323-463-2119 Fax: 323-463-0619 | |
Peter Lorber, M.d., A Medical Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1245 Wilshire Blvd, Suite 814, Los Angeles, CA 90017 Phone: 213-481-0592 | |
Satish S. Kadaba, M.d., Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4545 E 3rd St, Suite 102, Los Angeles, CA 90022 Phone: 323-264-6296 Fax: 323-264-6297 | |
Foundations Treatment Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11500 W Olympic Blvd Ste 420, Los Angeles, CA 90064 Phone: 888-800-5761 Fax: 818-530-7808 | |
Pch Treatment Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11965 Venice Blvd, Suite 407, Los Angeles, CA 90066 Phone: 310-566-7625 Fax: 310-566-7629 | |
Haleh Eghrari Psychology Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1314 Westwood Blvd, Suite 206, Los Angeles, CA 90024 Phone: 310-441-9550 Fax: 310-234-2682 | |
Douglas L. Gosney Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2566 Overland Ave, Suite 780, Los Angeles, CA 90064 Phone: 310-202-9382 |