Healthcare Provider Details

I. General information

NPI: 1548969751
Provider Name (Legal Business Name): CONSCIOUS PUZZLES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 DEEP VALLEY DR # 200-057
ROLLING HILLS ESTATES CA
90274-3629
US

IV. Provider business mailing address

3350 E 7TH ST # 338
LONG BEACH CA
90804-5003
US

V. Phone/Fax

Practice location:
  • Phone: 424-279-3898
  • Fax:
Mailing address:
  • Phone: 424-279-3898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PRINCESS OKIEME
Title or Position: PRESIDENT
Credential: LCSW
Phone: 424-279-3898