| Executive Mental Health, Inc. | |
|
11835 W Olympic Blvd Ste 1270e Los Angeles CA 90064-5001 | |
| (310) 273-4843 | |
| (310) 273-5056 |
| Full Name | Executive Mental Health, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 11835 W Olympic Blvd Ste 1270e, Los Angeles, California |
| Authorized Official Name and Position | Ari David Kalechstein (PRESIDENT/ OWNER) |
| Authorized Official Contact | 3102734843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Mental Health, Inc. 11835 W Olympic Blvd Ste 1270e Los Angeles CA 90064-5001 Ph: (310) 273-4843 | Executive Mental Health, Inc. 11835 W Olympic Blvd Ste 1270e Los Angeles CA 90064-5001 Ph: (310) 273-4843 |
| NPI Number | 1275670036 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 03/24/2023 |
| Certification Date | 03/24/2023 |
| Medicare PECOS PAC ID | 0345209102 |
|---|---|
| Medicare Enrollment ID | O20160512000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275670036 | NPI | - | NPPES |
| 546788 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PSY14872 (California) | Primary |
| Provider Name | Po-haong Lu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912922238 PECOS PAC ID: 7113086067 Enrollment ID: I20081106000386 |
| Provider Name | Jared C Kliger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477787802 PECOS PAC ID: 2860543808 Enrollment ID: I20090702000131 |
| Provider Name | William Shannon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063668275 PECOS PAC ID: 9638204761 Enrollment ID: I20100315000885 |
| Provider Name | Dylan G Harwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245337039 PECOS PAC ID: 0648440719 Enrollment ID: I20110826000667 |
| Provider Name | Lorraine P Leskin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952633398 PECOS PAC ID: 7416110762 Enrollment ID: I20120523000581 |
| Provider Name | Jennifer L Huggins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386787042 PECOS PAC ID: 3971767807 Enrollment ID: I20120605000756 |
| Provider Name | Omar Mendoza Mahmood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326309154 PECOS PAC ID: 7810153210 Enrollment ID: I20120731000254 |
| Provider Name | John Y Lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285890087 PECOS PAC ID: 0648416438 Enrollment ID: I20130424000273 |
| Provider Name | Elaine Rosa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154609311 PECOS PAC ID: 9335387281 Enrollment ID: I20130604000766 |
| Provider Name | Kyung H Lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356788244 PECOS PAC ID: 9638303357 Enrollment ID: I20131014000659 |
| Provider Name | Michelle Chih-shin Feng |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144688334 PECOS PAC ID: 3971807850 Enrollment ID: I20160215000073 |
| Provider Name | George E Vasquez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215478383 PECOS PAC ID: 7416224217 Enrollment ID: I20170526001997 |
| Provider Name | Earl Clare Thorndyke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184154726 PECOS PAC ID: 1456622869 Enrollment ID: I20170803001365 |
| Provider Name | Jennefer S Ho |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366953986 PECOS PAC ID: 0840556940 Enrollment ID: I20171106002260 |
| Provider Name | Kristen Virginia Eddy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013466994 PECOS PAC ID: 4486913175 Enrollment ID: I20180126000873 |
| Provider Name | Ron Stephen Valle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558552331 PECOS PAC ID: 2264784867 Enrollment ID: I20181009003820 |
| Provider Name | Nancy Stancil |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760840672 PECOS PAC ID: 0547509614 Enrollment ID: I20190307000975 |
| Provider Name | Allison Kay Hefley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558744938 PECOS PAC ID: 0244571149 Enrollment ID: I20190402001831 |
| Provider Name | Jennifer Lee Geren |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942699418 PECOS PAC ID: 1951642230 Enrollment ID: I20190415001702 |
| Provider Name | Jennifer Chua So |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891950820 PECOS PAC ID: 1658612890 Enrollment ID: I20190416001508 |
| Provider Name | Erin Nicole Waite |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407304090 PECOS PAC ID: 0749522837 Enrollment ID: I20190418002571 |
| Provider Name | Alexander Joseph Steiner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841551918 PECOS PAC ID: 8224369970 Enrollment ID: I20191009003517 |
| Provider Name | Sarah Fatoorechi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174955645 PECOS PAC ID: 1052746716 Enrollment ID: I20200128000000 |
| Provider Name | Alexis Ann Tsacoumangos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639607047 PECOS PAC ID: 2365870250 Enrollment ID: I20200306000819 |
| Provider Name | Sindy Oh-liverant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063611044 PECOS PAC ID: 4385072768 Enrollment ID: I20200318000672 |
| Provider Name | Brian Wen-long Wu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033637236 PECOS PAC ID: 2466879465 Enrollment ID: I20200903003355 |
| Provider Name | Molly Winter Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093453359 PECOS PAC ID: 2668856592 Enrollment ID: I20220826000734 |
| Provider Name | Autumn Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659409654 PECOS PAC ID: 3173990728 Enrollment ID: I20221110001727 |
| Provider Name | Jessica Joyce Carey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205967270 PECOS PAC ID: 7416328653 Enrollment ID: I20230125002431 |
| Provider Name | Jung Yun Jang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366157919 PECOS PAC ID: 2961874052 Enrollment ID: I20230220000595 |
| Provider Name | Omar Mendoza Mahmood |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1326309154 PECOS PAC ID: 7810153210 Enrollment ID: I20230316002678 |
| Provider Name | Courtney Crisp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902680564 PECOS PAC ID: 5890159503 Enrollment ID: I20230914000572 |
| Provider Name | Holly George |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295156289 PECOS PAC ID: 7315394988 Enrollment ID: I20231103002896 |
| Provider Name | Amanda Ting |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548030760 PECOS PAC ID: 0345685061 Enrollment ID: I20240304001440 |
| Provider Name | Dylan Vaughn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023875960 PECOS PAC ID: 3375980733 Enrollment ID: I20240320003042 |
| Provider Name | Enrique Ignacio Gracian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427706241 PECOS PAC ID: 5698116622 Enrollment ID: I20240508002798 |
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 |