Healthcare Provider Details

I. General information

NPI: 1851238018
Provider Name (Legal Business Name): EMOTIVA HEALTHCARE NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W OLIVE AVE FL 5
BURBANK CA
91505-4572
US

IV. Provider business mailing address

2600 W OLIVE AVE
BURBANK CA
91505-4549
US

V. Phone/Fax

Practice location:
  • Phone: 818-934-4505
  • Fax: 747-200-1307
Mailing address:
  • Phone: 310-906-8973
  • Fax: 747-200-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AHMAD QUDAIESAT
Title or Position: COFOUNDER
Credential: NP
Phone: 310-906-8973