| Tulaya Health | |
|
12381 Wilshire Blvd Ste 205 Los Angeles CA 90025-1063 | |
| (833) 867-2329 | |
| (833) 867-3757 |
| Full Name | Tulaya Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 12381 Wilshire Blvd Ste 205, Los Angeles, California |
| Authorized Official Name and Position | Thi Hoang (BUSINESS OFFICE) |
| Authorized Official Contact | 7022058232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tulaya Health 112 Via Sego Redondo Beach CA 90277-6429 Ph: (310) 990-6507 | Tulaya Health 12381 Wilshire Blvd Ste 205 Los Angeles CA 90025-1063 Ph: (833) 867-2329 |
| NPI Number | 1144879149 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 12/20/2023 |
| Certification Date | 12/20/2023 |
| Medicare PECOS PAC ID | 0749609956 |
|---|---|
| Medicare Enrollment ID | O20201007001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144879149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Nima Fahimian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437100278 PECOS PAC ID: 9638158025 Enrollment ID: I20040719000830 |
| Provider Name | Stephanie Ml Stewart |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831228394 PECOS PAC ID: 0244251312 Enrollment ID: I20051216000251 |
| Provider Name | Melanie Nicole Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376285965 PECOS PAC ID: 7810373404 Enrollment ID: I20221005001872 |
| Provider Name | Jacob Moussai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952494023 PECOS PAC ID: 2466450515 Enrollment ID: I20240426000046 |
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