| Mellow Medical Inc A Professional Corporation | |
|
8235 Santa Monica Blvd Suite 300 West Hollywood CA 90046-5914 | |
| (310) 892-4284 | |
| (323) 366-2966 |
| Full Name | Mellow Medical Inc A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8235 Santa Monica Blvd, West Hollywood, California |
| Authorized Official Name and Position | Lawrence Genen (CEO) |
| Authorized Official Contact | 3108924284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mellow Medical Inc A Professional Corporation 8235 Santa Monica Blvd Suite 300 West Hollywood CA 90046-5914 Ph: () - | Mellow Medical Inc A Professional Corporation 8235 Santa Monica Blvd Suite 300 West Hollywood CA 90046-5914 Ph: (310) 892-4284 |
| NPI Number | 1407275886 |
|---|---|
| Provider Enumeration Date | 04/14/2014 |
| Last Update Date | 04/22/2014 |
| Medicare PECOS PAC ID | 3375767403 |
|---|---|
| Medicare Enrollment ID | O20140611002222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407275886 | NPI | - | NPPES |
| Provider Name | Suzanne G Pike |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710030564 PECOS PAC ID: 6002896586 Enrollment ID: I20040723001133 |
| Provider Name | Nonnette H Mosley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649316043 PECOS PAC ID: 1456302587 Enrollment ID: I20050207000612 |
| Provider Name | Joel Fick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366442527 PECOS PAC ID: 6305875618 Enrollment ID: I20050808000278 |
| Provider Name | Glenn R Powers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194782789 PECOS PAC ID: 1052413895 Enrollment ID: I20070224000080 |
| Provider Name | Sabrina L Friedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194889519 PECOS PAC ID: 0143321166 Enrollment ID: I20070720000566 |
| Provider Name | Marita G Dailo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326053174 PECOS PAC ID: 7719055953 Enrollment ID: I20081001000466 |
| Provider Name | Cynthia Loebig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841407582 PECOS PAC ID: 4587729199 Enrollment ID: I20090216000135 |
| Provider Name | Michael E Glasser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568601359 PECOS PAC ID: 1355480740 Enrollment ID: I20091124000328 |
| Provider Name | Deborah K Lucas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376758128 PECOS PAC ID: 8820281488 Enrollment ID: I20101015000419 |
| Provider Name | Joseph C Tu |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1710109905 PECOS PAC ID: 2264628700 Enrollment ID: I20101123001223 |
| Provider Name | Norman R Bentson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588935100 PECOS PAC ID: 9537327317 Enrollment ID: I20120224000503 |
| Provider Name | Micah T Hoffman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649565417 PECOS PAC ID: 8426297417 Enrollment ID: I20130624000655 |
| Provider Name | Priyamvada Narayanan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346466067 PECOS PAC ID: 2264324995 Enrollment ID: I20130724000284 |
| Provider Name | Holly Landry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427317874 PECOS PAC ID: 4183865322 Enrollment ID: I20130730000749 |
| Provider Name | Nam A Dao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285061168 PECOS PAC ID: 5294962742 Enrollment ID: I20131209001116 |
| Provider Name | Marija Petrovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013081835 PECOS PAC ID: 6800946518 Enrollment ID: I20140414001235 |
| Provider Name | Robert Haskell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558686501 PECOS PAC ID: 4880818434 Enrollment ID: I20140621000081 |
| Provider Name | Radhika Katyal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306089164 PECOS PAC ID: 3577780220 Enrollment ID: I20140804002110 |
| Provider Name | Galya Rees |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760742357 PECOS PAC ID: 5890913461 Enrollment ID: I20140822000844 |
| Provider Name | Toni A Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356752786 PECOS PAC ID: 0941429286 Enrollment ID: I20140918000250 |
| Provider Name | Thomas Rankin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467893560 PECOS PAC ID: 2163740945 Enrollment ID: I20150407000332 |
| Provider Name | Janice K Mcnamara |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477886638 PECOS PAC ID: 9032438825 Enrollment ID: I20150429000285 |
| Provider Name | Daniel N Pistone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962405084 PECOS PAC ID: 2062490113 Enrollment ID: I20150520001213 |
| Provider Name | Sarah Alia Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568740538 PECOS PAC ID: 5991943011 Enrollment ID: I20150916003491 |
| Provider Name | Jeremy Armien Handy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437371671 PECOS PAC ID: 2769665389 Enrollment ID: I20151211000055 |
| Provider Name | Cynthia Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508014143 PECOS PAC ID: 7315241874 Enrollment ID: I20160204000444 |
| Provider Name | Marilu Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962782276 PECOS PAC ID: 6103121637 Enrollment ID: I20160222001925 |
| Provider Name | Ashley Cyronak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639542749 PECOS PAC ID: 7911204870 Enrollment ID: I20160321002567 |
| Provider Name | Karl Gundersen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548362775 PECOS PAC ID: 8729237656 Enrollment ID: I20160322002267 |
| Provider Name | Cindy B Illescas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720449358 PECOS PAC ID: 8224335971 Enrollment ID: I20160324001024 |
| Provider Name | Cassandra Klyman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649226234 PECOS PAC ID: 6901988237 Enrollment ID: I20160624000778 |
| Provider Name | Marina Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134552953 PECOS PAC ID: 0244525327 Enrollment ID: I20160829001762 |
| Provider Name | Fariba Mansouri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073995452 PECOS PAC ID: 8022304914 Enrollment ID: I20160831002745 |
| Provider Name | Behrouz Namdari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972829711 PECOS PAC ID: 8022304856 Enrollment ID: I20160902002040 |
| Provider Name | Dede E Echitey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821474412 PECOS PAC ID: 8426366212 Enrollment ID: I20160920002780 |
| Provider Name | Fady S Boules |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639541022 PECOS PAC ID: 8527356773 Enrollment ID: I20161004002021 |
| Provider Name | Nima Nouri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639308117 PECOS PAC ID: 0941598239 Enrollment ID: I20161020000132 |
| Provider Name | Lauran Jacks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093855090 PECOS PAC ID: 3779647086 Enrollment ID: I20161117000982 |
| Provider Name | Robertino D Lim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215318134 PECOS PAC ID: 2668751298 Enrollment ID: I20161122001195 |
| Provider Name | Slobodan Nesovic |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811147713 PECOS PAC ID: 6305125881 Enrollment ID: I20161128002388 |
| Provider Name | Gloria Sudeta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083070064 PECOS PAC ID: 7810285210 Enrollment ID: I20161130001840 |
| Provider Name | John D Vancamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982156873 PECOS PAC ID: 0345521274 Enrollment ID: I20170106001447 |
| Provider Name | Chau Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225484066 PECOS PAC ID: 9436430378 Enrollment ID: I20170106001846 |
| Provider Name | Melissa A Jethanandani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508974791 PECOS PAC ID: 0244271401 Enrollment ID: I20170405002232 |
| Provider Name | Lori L Lariviere |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407022106 PECOS PAC ID: 8729229828 Enrollment ID: I20170410001422 |
| Provider Name | Uchechi L Nwosu-iroha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306211081 PECOS PAC ID: 9032496211 Enrollment ID: I20170426002246 |
| Provider Name | Rashida Michelle Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740698430 PECOS PAC ID: 1355633322 Enrollment ID: I20170522000289 |
| Provider Name | Jodi Cp Cabrera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134370893 PECOS PAC ID: 0547531550 Enrollment ID: I20170810000197 |
| Provider Name | Sumit Naig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437491321 PECOS PAC ID: 7719117472 Enrollment ID: I20171010002992 |
| Provider Name | Sharon Clay Matemavi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144213091 PECOS PAC ID: 6608813118 Enrollment ID: I20171019003186 |
| Provider Name | Alaleh K Selkirk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952705162 PECOS PAC ID: 6204192727 Enrollment ID: I20171115002944 |
| Provider Name | Naser Ahmadi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497019806 PECOS PAC ID: 7214176114 Enrollment ID: I20171229002414 |
| Provider Name | Richard P Heidenfelder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700984911 PECOS PAC ID: 1658630058 Enrollment ID: I20180110001037 |
| Provider Name | Lilian Okoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518359355 PECOS PAC ID: 2264792258 Enrollment ID: I20180213001307 |
| Provider Name | Cory Daniel Mcnamara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114218351 PECOS PAC ID: 4486891983 Enrollment ID: I20180508002027 |
| Provider Name | Katherine C Oring |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598025215 PECOS PAC ID: 1658635198 Enrollment ID: I20180508002822 |
| Provider Name | Medard Sison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922507037 PECOS PAC ID: 8820352057 Enrollment ID: I20180515002925 |
| Provider Name | Grashika Sonal Devendra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407286743 PECOS PAC ID: 4789939810 Enrollment ID: I20180613003382 |
| Provider Name | Marjan K Khanjan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275610552 PECOS PAC ID: 7113273335 Enrollment ID: I20180702000555 |
| Provider Name | John Koleth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902086770 PECOS PAC ID: 6800970294 Enrollment ID: I20180905002012 |
| Provider Name | Dominique Tiera Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164946992 PECOS PAC ID: 1658622592 Enrollment ID: I20180917000896 |
| Provider Name | Tara Payel Arnold |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770967291 PECOS PAC ID: 0446501985 Enrollment ID: I20180924001279 |
| Provider Name | Ron Stephen Valle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558552331 PECOS PAC ID: 2264784867 Enrollment ID: I20181009003820 |
| Provider Name | Linda Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073096053 PECOS PAC ID: 9739432709 Enrollment ID: I20181022003262 |
| Provider Name | Tristin W Engels |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427313204 PECOS PAC ID: 4587918578 Enrollment ID: I20181109001339 |
| Provider Name | Gary Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871630160 PECOS PAC ID: 9032463906 Enrollment ID: I20181112001923 |
| Provider Name | Ladan Boustani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174098974 PECOS PAC ID: 2163776691 Enrollment ID: I20181119002305 |
| Provider Name | Stephanie A Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033431044 PECOS PAC ID: 9032456538 Enrollment ID: I20190122002307 |
| Provider Name | Lili Ana Sanchez-cordova |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023362167 PECOS PAC ID: 0042552184 Enrollment ID: I20190422001027 |
| Provider Name | Britney Shipman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891264552 PECOS PAC ID: 2769725761 Enrollment ID: I20190514003172 |
| Provider Name | Katherine S Geelan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861706111 PECOS PAC ID: 9335482843 Enrollment ID: I20190524002465 |
| Provider Name | Karen Tracy Collica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245673581 PECOS PAC ID: 0143563569 Enrollment ID: I20190528000746 |
| Provider Name | Rebecca Rose Bonneville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821424375 PECOS PAC ID: 9335413004 Enrollment ID: I20190529003203 |
| Provider Name | Tara L Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033558820 PECOS PAC ID: 4385885441 Enrollment ID: I20190611002723 |
| Provider Name | Karen Esther Meske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336600410 PECOS PAC ID: 9931434354 Enrollment ID: I20190708001911 |
| Provider Name | David Ngo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245610948 PECOS PAC ID: 0547596603 Enrollment ID: I20190726000797 |
| Provider Name | Angela K Sureen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457762346 PECOS PAC ID: 3072840560 Enrollment ID: I20190806003375 |
| Provider Name | Nectar Redman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760871628 PECOS PAC ID: 1052745130 Enrollment ID: I20191224000319 |
| Provider Name | Miyeon Vivienne Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295259141 PECOS PAC ID: 1951735034 Enrollment ID: I20191224000378 |
| Provider Name | Tanyna B Sosa-williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174957518 PECOS PAC ID: 2062847593 Enrollment ID: I20200110001256 |
| Provider Name | Jennifer Knisely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992276679 PECOS PAC ID: 9830525674 Enrollment ID: I20200214000322 |
| Provider Name | Dominique L Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124589163 PECOS PAC ID: 5890123186 Enrollment ID: I20200320000233 |
| Provider Name | Carolyn Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124429857 PECOS PAC ID: 4981915873 Enrollment ID: I20200424002305 |
| Provider Name | Erika Allen-andere |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659757391 PECOS PAC ID: 4486084886 Enrollment ID: I20200427002482 |
| Provider Name | Jeshmin Bhaju |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497081566 PECOS PAC ID: 5698801033 Enrollment ID: I20200428000468 |
| Provider Name | Kristin Ratz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740668193 PECOS PAC ID: 8729353818 Enrollment ID: I20200604000402 |
| Provider Name | Philip Madden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568840197 PECOS PAC ID: 2668893314 Enrollment ID: I20200604000944 |
| Provider Name | Veronica Kamau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275166381 PECOS PAC ID: 3678997699 Enrollment ID: I20200723002343 |
| Provider Name | Thais Siewert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194348318 PECOS PAC ID: 6901222918 Enrollment ID: I20200820001080 |
| Provider Name | Jonathan Allan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144675919 PECOS PAC ID: 4981998077 Enrollment ID: I20200903000277 |
| Provider Name | Farooque Azam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689203093 PECOS PAC ID: 0941627988 Enrollment ID: I20200904001152 |
| Provider Name | Regina Umukoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184080798 PECOS PAC ID: 2668890377 Enrollment ID: I20200911002503 |
| Provider Name | Jamesina Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689192049 PECOS PAC ID: 1658791371 Enrollment ID: I20201020000162 |
| Provider Name | Stacey Heit |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700965175 PECOS PAC ID: 1052371374 Enrollment ID: I20201104002994 |
| Provider Name | Diana Uribe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346555158 PECOS PAC ID: 4587074117 Enrollment ID: I20201110000752 |
| Provider Name | Maria Carina Abenes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073076899 PECOS PAC ID: 2365853496 Enrollment ID: I20201123000231 |
| Provider Name | Rebecca Warren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457649147 PECOS PAC ID: 1153732987 Enrollment ID: I20201130000242 |
| Provider Name | Franchesca Chevonne Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578186417 PECOS PAC ID: 7214342880 Enrollment ID: I20210211001657 |
| Provider Name | Margaret Hank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740746726 PECOS PAC ID: 6507271723 Enrollment ID: I20210222002383 |
| Provider Name | Omotayo Alamutu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689978652 PECOS PAC ID: 0840628426 Enrollment ID: I20210226001402 |
| Provider Name | Kensie L Hoag |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265966576 PECOS PAC ID: 0446667984 Enrollment ID: I20210329001057 |
| Provider Name | Cheyanne Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265034912 PECOS PAC ID: 7911307202 Enrollment ID: I20210608001487 |
| Provider Name | Roshan Koozekanani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407878515 PECOS PAC ID: 8123024429 Enrollment ID: I20210713003684 |
| Provider Name | Elham Hamzeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265041511 PECOS PAC ID: 7810202256 Enrollment ID: I20210901003673 |
| Provider Name | Denis Tamas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659991289 PECOS PAC ID: 6002213014 Enrollment ID: I20210917001117 |
| Provider Name | Oluseun Ofuje Ajayi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114389178 PECOS PAC ID: 5193011591 Enrollment ID: I20210917002848 |
| Provider Name | Sandra Darby Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700369378 PECOS PAC ID: 0345588455 Enrollment ID: I20210920001817 |
| Provider Name | Joy Egungwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194300459 PECOS PAC ID: 4587053566 Enrollment ID: I20211112000906 |
| Provider Name | Shalesse Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750045712 PECOS PAC ID: 3870983364 Enrollment ID: I20211123002063 |
| Provider Name | John Whittier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225562564 PECOS PAC ID: 8022408525 Enrollment ID: I20211123002520 |
| Provider Name | Lorelei H Dumaplin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306110986 PECOS PAC ID: 3274923008 Enrollment ID: I20211209000485 |
| Provider Name | Kemi E Fawehinmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720593981 PECOS PAC ID: 3870854250 Enrollment ID: I20211213001019 |
| Provider Name | Harrieth Amaka Madu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023685021 PECOS PAC ID: 8729479274 Enrollment ID: I20211217000604 |
| Provider Name | Johnny Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003313461 PECOS PAC ID: 7315378387 Enrollment ID: I20211217000771 |
| Provider Name | Mustafa Zaidi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275775116 PECOS PAC ID: 2567732977 Enrollment ID: I20211221002420 |
| Provider Name | Doris Cudjoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669098356 PECOS PAC ID: 6305240169 Enrollment ID: I20220104001875 |
| Provider Name | Brittany Bettingen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952930588 PECOS PAC ID: 9638563018 Enrollment ID: I20220301000726 |
| Provider Name | Tina Francis Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396406831 PECOS PAC ID: 8224416300 Enrollment ID: I20220601002058 |
| Provider Name | Christian Ortiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497031454 PECOS PAC ID: 8224271325 Enrollment ID: I20220602002446 |
| Provider Name | Duy Tran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386900561 PECOS PAC ID: 5496056517 Enrollment ID: I20220602002488 |
| Provider Name | Brittany G Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558011296 PECOS PAC ID: 6608254685 Enrollment ID: I20220602002833 |
| Provider Name | Anthony N Quilon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972037083 PECOS PAC ID: 3072991918 Enrollment ID: I20220603002187 |
| Provider Name | Alicia Maria Barrs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427107085 PECOS PAC ID: 2163417957 Enrollment ID: I20220606002195 |
| Provider Name | Lilian Enibokun Bamgbose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538750559 PECOS PAC ID: 3173901824 Enrollment ID: I20220608001322 |
| Provider Name | Alan R Flitton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356488217 PECOS PAC ID: 8426436031 Enrollment ID: I20220609000619 |
| Provider Name | Mark Schlotterback |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346775921 PECOS PAC ID: 2567840085 Enrollment ID: I20220611000001 |
| Provider Name | Maren K Batts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740775121 PECOS PAC ID: 9436538931 Enrollment ID: I20220613002613 |
| Provider Name | Bishoy Michael |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932631751 PECOS PAC ID: 0446537773 Enrollment ID: I20220614001947 |
| Provider Name | Mayra Fabiola Covarrubias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174076871 PECOS PAC ID: 1355720756 Enrollment ID: I20220615000598 |
| Provider Name | Yalda Safai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508376864 PECOS PAC ID: 9537572029 Enrollment ID: I20220615002030 |
| Provider Name | Stephanie Mittauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679063226 PECOS PAC ID: 4486033834 Enrollment ID: I20220615002383 |
| Provider Name | Jacqueline Pusateri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861675761 PECOS PAC ID: 8325427784 Enrollment ID: I20220615002614 |
| Provider Name | Bonnie Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154374478 PECOS PAC ID: 9931198942 Enrollment ID: I20220616001632 |
| Provider Name | Amara Toure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043869365 PECOS PAC ID: 0143654095 Enrollment ID: I20220622001539 |
| Provider Name | Jenna Shock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255984738 PECOS PAC ID: 3870825805 Enrollment ID: I20220622002666 |
| Provider Name | Doreen Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942831565 PECOS PAC ID: 8123424181 Enrollment ID: I20220623000582 |
| Provider Name | Lori L. Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720312606 PECOS PAC ID: 5991184806 Enrollment ID: I20220623002645 |
| Provider Name | Justin Scott Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184373474 PECOS PAC ID: 3476932286 Enrollment ID: I20220624002647 |
| Provider Name | Brittney Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396496477 PECOS PAC ID: 2668852005 Enrollment ID: I20220701002097 |
| Provider Name | Timothy Braga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184268054 PECOS PAC ID: 7719377381 Enrollment ID: I20220705000771 |
| Provider Name | Anton Power |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285175075 PECOS PAC ID: 4688054505 Enrollment ID: I20220708001668 |
| Provider Name | Sheila Barthelemy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912585787 PECOS PAC ID: 6002297496 Enrollment ID: I20220715002520 |
| Provider Name | Kywina Marie Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609079839 PECOS PAC ID: 7911388053 Enrollment ID: I20220720001664 |
| Provider Name | Bronwyn Dilley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407809072 PECOS PAC ID: 2860416369 Enrollment ID: I20220805002484 |
| Provider Name | Ijeoma Eze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154905081 PECOS PAC ID: 1658777594 Enrollment ID: I20220808001544 |
| Provider Name | Ahamefule Epoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174285852 PECOS PAC ID: 4486037801 Enrollment ID: I20220818000479 |
| Provider Name | Odiri Akushe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023496726 PECOS PAC ID: 3072524685 Enrollment ID: I20220902001026 |
| Provider Name | Harold Wayne Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417602046 PECOS PAC ID: 9537543947 Enrollment ID: I20220902002881 |
| Provider Name | Len Umayam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710594916 PECOS PAC ID: 5890179170 Enrollment ID: I20220906001901 |
| Provider Name | Jennifer Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639718323 PECOS PAC ID: 7618352758 Enrollment ID: I20220909002950 |
| Provider Name | Alexander Anthony Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023581303 PECOS PAC ID: 5496130601 Enrollment ID: I20220923000444 |
| Provider Name | Marvin Hoang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558083121 PECOS PAC ID: 0840666715 Enrollment ID: I20221018000766 |
| Provider Name | Oscar Brian Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396382206 PECOS PAC ID: 0446626345 Enrollment ID: I20221018001757 |
| Provider Name | Elizabeth Nnenna Emeri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649897174 PECOS PAC ID: 1355757857 Enrollment ID: I20221025002973 |
| Provider Name | Gardine Jacques |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720357023 PECOS PAC ID: 6608022322 Enrollment ID: I20221026003102 |
| Provider Name | Fines Pafira Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467095224 PECOS PAC ID: 8426425091 Enrollment ID: I20221110002804 |
| Provider Name | Angel Uzoma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932847241 PECOS PAC ID: 7416325808 Enrollment ID: I20221115003310 |
| Provider Name | Holly J Beene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962089383 PECOS PAC ID: 4284002650 Enrollment ID: I20221116002883 |
| Provider Name | Amenaghawon Alice Ugwuede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780347955 PECOS PAC ID: 5890163935 Enrollment ID: I20221122001182 |
| Provider Name | Adriane English-mooring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083952832 PECOS PAC ID: 3779997051 Enrollment ID: I20221122001927 |
| Provider Name | Tenni O John-idiagbonya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053850008 PECOS PAC ID: 2668840638 Enrollment ID: I20221122003094 |
| Provider Name | Lisa Ann Degraff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588399737 PECOS PAC ID: 5092183004 Enrollment ID: I20221123001030 |
| Provider Name | Salina Arutyunyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205574076 PECOS PAC ID: 0840668869 Enrollment ID: I20221123001364 |
| Provider Name | Victoria Esso Omson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548989965 PECOS PAC ID: 6507234473 Enrollment ID: I20221128000219 |
| Provider Name | Jessica L Parente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184233926 PECOS PAC ID: 3375911258 Enrollment ID: I20221128000462 |
| Provider Name | Kosi Obialor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336861632 PECOS PAC ID: 3779951421 Enrollment ID: I20221130001720 |
| Provider Name | Lizette Ebot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508448739 PECOS PAC ID: 8527466168 Enrollment ID: I20221205000210 |
| Provider Name | Anthony Lorenza Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568191245 PECOS PAC ID: 8123497617 Enrollment ID: I20221205002247 |
| Provider Name | Joecoline Nwachukwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386377612 PECOS PAC ID: 2769851997 Enrollment ID: I20221212000320 |
| Provider Name | Evalynn Michele Natarajan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285372417 PECOS PAC ID: 8022156991 Enrollment ID: I20221213001330 |
| Provider Name | Lalaine Garcia Otadoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275254286 PECOS PAC ID: 3870962905 Enrollment ID: I20221213001574 |
| Provider Name | Ngozi C Onyenuforo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306562335 PECOS PAC ID: 9638548670 Enrollment ID: I20221213002320 |
| Provider Name | Nicole E Bellisario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982172003 PECOS PAC ID: 1557730512 Enrollment ID: I20221213003272 |
| Provider Name | Jennifer Arzate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952028060 PECOS PAC ID: 9436528213 Enrollment ID: I20221219000686 |
| Provider Name | Amara J Ezumah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427770940 PECOS PAC ID: 2961872601 Enrollment ID: I20221221002149 |
| Provider Name | Kevin W Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225753460 PECOS PAC ID: 6103296710 Enrollment ID: I20221222001876 |
| Provider Name | Luis Carlos Richter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194030072 PECOS PAC ID: 5496125023 Enrollment ID: I20221222002708 |
| Provider Name | Anna Ly Pathammavong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447684253 PECOS PAC ID: 2668842220 Enrollment ID: I20221224000002 |
| Provider Name | Tiffany Mattox-rubin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700373115 PECOS PAC ID: 5890165302 Enrollment ID: I20221227002283 |
| Provider Name | Rosemond Ijeoma Ijioma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285133157 PECOS PAC ID: 9032589445 Enrollment ID: I20221229001485 |
| Provider Name | Summer Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285827949 PECOS PAC ID: 8022491489 Enrollment ID: I20230104002342 |
| Provider Name | Sima Dinari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346965704 PECOS PAC ID: 8628448586 Enrollment ID: I20230110002821 |
| Provider Name | Elaine Frances Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619505575 PECOS PAC ID: 6204207095 Enrollment ID: I20230112002972 |
| Provider Name | Armen Saribegian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750962676 PECOS PAC ID: 6406227248 Enrollment ID: I20230113002124 |
| Provider Name | Jennifer Ann Java |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053046912 PECOS PAC ID: 6901277268 Enrollment ID: I20230124001506 |
| Provider Name | Karen Newton Vertti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477228567 PECOS PAC ID: 0244601201 Enrollment ID: I20230130002456 |
| Provider Name | Valery Volcy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831728013 PECOS PAC ID: 2567834427 Enrollment ID: I20230202002516 |
| Provider Name | Amy Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295272318 PECOS PAC ID: 5991177404 Enrollment ID: I20230209002559 |
| Provider Name | Julie Lauren Tatian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538890512 PECOS PAC ID: 1850763038 Enrollment ID: I20230216001548 |
| Provider Name | Victoria Chigbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659078426 PECOS PAC ID: 8224401237 Enrollment ID: I20230222000901 |
| Provider Name | Michael Olusegun Adeduro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386352789 PECOS PAC ID: 7618340449 Enrollment ID: I20230227001339 |
| Provider Name | Leslie Gacad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487350682 PECOS PAC ID: 7517330368 Enrollment ID: I20230227001846 |
| Provider Name | Karen Vogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033836226 PECOS PAC ID: 5698148773 Enrollment ID: I20230310002361 |
| Provider Name | Dana Ebeling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114353588 PECOS PAC ID: 4082840673 Enrollment ID: I20230324001526 |
| Provider Name | Rachel Ashiokai Otubuah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902557192 PECOS PAC ID: 7911372081 Enrollment ID: I20230404001655 |
| Provider Name | Fariba Mazdeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669786117 PECOS PAC ID: 3072706704 Enrollment ID: I20230417001952 |
| Provider Name | Allysen Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689101362 PECOS PAC ID: 7012382476 Enrollment ID: I20230417002322 |
| Provider Name | Chioma Onodugo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528521499 PECOS PAC ID: 9739544420 Enrollment ID: I20230502002976 |
| Provider Name | Ijeoma Tina Nwokoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811648876 PECOS PAC ID: 6204291776 Enrollment ID: I20230505001248 |
| Provider Name | Oriana Hashemi-toroghi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609487529 PECOS PAC ID: 7618333931 Enrollment ID: I20230511001889 |
| Provider Name | Tiffany Nicole Guthrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417654914 PECOS PAC ID: 7315303633 Enrollment ID: I20230511002093 |
| Provider Name | Jan Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134498884 PECOS PAC ID: 5496111668 Enrollment ID: I20230512000883 |
| Provider Name | Steven R Rolnick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902815343 PECOS PAC ID: 7416911730 Enrollment ID: I20230523002352 |
| Provider Name | Mohammad Alinejad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497471825 PECOS PAC ID: 4587021001 Enrollment ID: I20230526002143 |
| Provider Name | Amy Angela Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659094761 PECOS PAC ID: 3870953730 Enrollment ID: I20230724003628 |
| Provider Name | Lydia Owuor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700080744 PECOS PAC ID: 2769844752 Enrollment ID: I20230808001001 |
The Hollywood Therapist Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7104 Franklin Ave Apt 12, West Hollywood, CA 90046 Phone: 619-309-8291 | |
Maria Brickman, M.d. A Medical Corporation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9229 W Sunset Blvd, Suite 220, West Hollywood, CA 90069 Phone: 323-658-7655 | |
Jewish Family Service Of La Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7362 Santa Monica Blvd, West Hollywood, CA 90046 Phone: 323-883-0330 Fax: 323-883-0344 | |
New Way Pain Relief, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 874 Hammond St Apt 14, West Hollywood, CA 90069 Phone: 323-556-3470 | |
Insight Choices Mental Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8265 W Sunset Blvd Ste 207, West Hollywood, CA 90046 Phone: 323-375-0950 Fax: 323-315-5240 | |
Jeffrey R. Yates Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 N Almont Dr, West Hollywood, CA 90048 Phone: 310-800-8994 | |
Regina Berkovich Md Phd Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8727 Beverly Blvd Ste B, West Hollywood, CA 90048 Phone: 310-474-9595 |