Healthcare Provider Details

I. General information

NPI: 1013857424
Provider Name (Legal Business Name): SAFE SPACE VENTURES, A PROFESSIONAL NURSING CORPORATION DBA ISTRIVE MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 6TH ST STE 202A
SANTA MONICA CA
90401-2513
US

IV. Provider business mailing address

1513 6TH ST STE 202A
SANTA MONICA CA
90401-2513
US

V. Phone/Fax

Practice location:
  • Phone: 213-808-4417
  • Fax: 213-283-9675
Mailing address:
  • Phone: 213-808-4417
  • Fax: 213-283-9675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMBER MITCHELL
Title or Position: OWNER
Credential: NP
Phone: 213-808-4417