Healthcare Provider Details

I. General information

NPI: 1598699282
Provider Name (Legal Business Name): INNER LIGHT PSYCHOLOGICAL INSIGHTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N BROADWAY STE 42957
LOS ANGELES CA
90012-1408
US

IV. Provider business mailing address

1301 N BROADWAY STE 42957
LOS ANGELES CA
90012-1408
US

V. Phone/Fax

Practice location:
  • Phone: 424-655-3450
  • Fax: 424-788-5572
Mailing address:
  • Phone: 424-655-3450
  • Fax: 424-788-5572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: EMILY J CAMPBELL
Title or Position: CO-CEO
Credential: PHD
Phone: 424-655-3450