Healthcare Provider Details

I. General information

NPI: 1780526327
Provider Name (Legal Business Name): MINDFUL PLAY PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11145 TAMPA AVE STE 12B
PORTER RANCH CA
91326-2215
US

IV. Provider business mailing address

11145 TAMPA AVE STE 12B
PORTER RANCH CA
91326-2215
US

V. Phone/Fax

Practice location:
  • Phone: 818-336-1644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: AURIELLE MASON
Title or Position: CEO
Credential: PSY.D.
Phone: 818-336-1644