Healthcare Provider Details

I. General information

NPI: 1649046426
Provider Name (Legal Business Name): KUDOS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 WEST BLVD APT 306
LOS ANGELES CA
90043-3869
US

IV. Provider business mailing address

6400 WEST BLVD APT 306
LOS ANGELES CA
90043-3869
US

V. Phone/Fax

Practice location:
  • Phone: 323-802-3928
  • Fax:
Mailing address:
  • Phone: 323-802-3928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN ESHUN
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 323-802-3928