Healthcare Provider Details

I. General information

NPI: 1245892637
Provider Name (Legal Business Name): HEALING RHYTHMS MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 07/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 1/2 S MYRTLE AVE STE 910
MONROVIA CA
91016-5189
US

IV. Provider business mailing address

521 1/2 S MYRTLE AVE STE 910
MONROVIA CA
91016-5189
US

V. Phone/Fax

Practice location:
  • Phone: 626-940-8670
  • Fax: 562-869-5376
Mailing address:
  • Phone: 626-940-8670
  • Fax: 562-869-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNY BRAGANZA
Title or Position: CREDENTAILING MANAGER
Credential:
Phone: 562-403-4422