| New Moon Wellness Inc. | |
|
16661 Ventura Blvd Ste 400 Encino CA 91436-1925 | |
| (818) 579-2258 | |
| Not Available |
| Full Name | New Moon Wellness Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 16661 Ventura Blvd Ste 400, Encino, California |
| Authorized Official Name and Position | Natalie Madriz (CO FOUNDER) |
| Authorized Official Contact | 8185792258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Moon Wellness Inc. 11054 Ventura Blvd # 245 Studio City CA 91604-3546 Ph: (818) 579-2258 | New Moon Wellness Inc. 16661 Ventura Blvd Ste 400 Encino CA 91436-1925 Ph: (818) 579-2258 |
| NPI Number | 1164074902 |
|---|---|
| Provider Enumeration Date | 07/11/2019 |
| Last Update Date | 07/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164074902 | NPI | - | NPPES |
| 1669772166 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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