| Golden State Neuroplastics | |
|
757 Ridgeside Dr Monrovia CA 91016-1721 | |
| (213) 260-0605 | |
| (888) 789-9773 |
| Full Name | Golden State Neuroplastics |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 757 Ridgeside Dr, Monrovia, California |
| Authorized Official Name and Position | Christopher Bartlett Franklin (CEO) |
| Authorized Official Contact | 3108636199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden State Neuroplastics 1323 W Francisquito Ave #80 West Covina CA 91790-4656 Ph: (310) 863-6199 | Golden State Neuroplastics 757 Ridgeside Dr Monrovia CA 91016-1721 Ph: (213) 260-0605 |
| NPI Number | 1417332545 |
|---|---|
| Provider Enumeration Date | 07/30/2015 |
| Last Update Date | 09/06/2024 |
| Certification Date | 09/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417332545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | PSY24447 (California) | Primary |
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