Healthcare Provider Details

I. General information

NPI: 1679136634
Provider Name (Legal Business Name): HEALING RHYTHMS PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 1/2 S MYRTLE AVE STE 9&10
MONROVIA CA
91016-5189
US

IV. Provider business mailing address

521 1/2 S MYRTLE AVE STE 9
MONROVIA CA
91016-5131
US

V. Phone/Fax

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

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: WAYNE KAO
Title or Position: PRESIDENT
Credential: MD
Phone: 626-940-6744