| Myndheal, Corp | |
|
20721 Lemarsh St Chatsworth CA 91311-3266 | |
| (916) 400-0633 | |
| Not Available |
| Full Name | Myndheal, Corp |
|---|---|
| Speciality | Social Worker |
| Location | 20721 Lemarsh St, Chatsworth, California |
| Authorized Official Name and Position | Ajita Gupta (CEO) |
| Authorized Official Contact | 9164000633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myndheal, Corp Po Box 3663 Chatsworth CA 91313-3663 Ph: () - | Myndheal, Corp 20721 Lemarsh St Chatsworth CA 91311-3266 Ph: (916) 400-0633 |
| NPI Number | 1245874163 |
|---|---|
| Provider Enumeration Date | 11/04/2019 |
| Last Update Date | 05/23/2022 |
| Certification Date | 05/23/2022 |
| Medicare PECOS PAC ID | 0244665255 |
|---|---|
| Medicare Enrollment ID | O20200122001177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245874163 | NPI | - | NPPES |
| Provider Name | Ajita Gupta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073093142 PECOS PAC ID: 6002241007 Enrollment ID: I20200122001020 |
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