Healthcare Provider Details

I. General information

NPI: 1023966033
Provider Name (Legal Business Name): LOTUS ONE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 NORMANDIE AVE #10
LOS ANGELES CA
90027
US

IV. Provider business mailing address

5665 WILSHIRE BLVD UNIT 1351
LOS ANGELES CA
90036-3710
US

V. Phone/Fax

Practice location:
  • Phone: 213-407-5529
  • Fax:
Mailing address:
  • Phone: 213-407-5528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: YONNI-SHEILA HAN
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 213-407-5529