Healthcare Provider Details

I. General information

NPI: 1336051515
Provider Name (Legal Business Name): BE PARTICULAR PEER SUPPORT EDUCATION & NAVIGATION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8939 S SEPULVEDA BLVD STE 102
LOS ANGELES CA
90045-3605
US

IV. Provider business mailing address

500 EVERGREEN ST UNIT 309
INGLEWOOD CA
90302-7257
US

V. Phone/Fax

Practice location:
  • Phone: 310-678-2195
  • Fax: 213-224-0945
Mailing address:
  • Phone: 310-678-2195
  • Fax: 213-224-0945

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: MR. RANDALL NELSON CLARY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 310-678-2195