Healthcare Provider Details

I. General information

NPI: 1578496816
Provider Name (Legal Business Name): MATERNAL MENTAL HEALTH NOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11980 SAN VICENTE BLVD STE 909
LOS ANGELES CA
90049-6607
US

IV. Provider business mailing address

1308 E COLORADO BLVD UNIT 3203
PASADENA CA
91106-1932
US

V. Phone/Fax

Practice location:
  • Phone: 646-704-2688
  • Fax:
Mailing address:
  • Phone: 646-704-2688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: KELLY O'CONNOR KAY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 646-704-2688