Healthcare Provider Details

I. General information

NPI: 1659126134
Provider Name (Legal Business Name): MIND PULSE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD STE M100
PASADENA CA
91101-2039
US

IV. Provider business mailing address

595 E COLORADO BLVD STE M100
PASADENA CA
91101-2039
US

V. Phone/Fax

Practice location:
  • Phone: 626-703-5643
  • Fax: 626-470-9718
Mailing address:
  • Phone: 626-703-5643
  • Fax: 626-470-9718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVE KHACHI
Title or Position: PRESIDENT
Credential: MD
Phone: 626-765-4045