Healthcare Provider Details

I. General information

NPI: 1992623987
Provider Name (Legal Business Name): UCLA TELE-MENTAL HEALTH HUB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 WESTWOOD PLZ
LOS ANGELES CA
90095-8353
US

IV. Provider business mailing address

740 WESTWOOD PLZ
LOS ANGELES CA
90095-8353
US

V. Phone/Fax

Practice location:
  • Phone: 310-794-4164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: SEAN MINNS
Title or Position: STUDENT IN AN ORGANIZED HEALTHCARE
Credential:
Phone: 713-502-5767