Healthcare Provider Details

I. General information

NPI: 1881507648
Provider Name (Legal Business Name): PROJECT OPTIMISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 E 29TH ST STE 203
SIGNAL HILL CA
90755-1824
US

IV. Provider business mailing address

4508 ATLANTIC AVE # A434
LONG BEACH CA
90807-1520
US

V. Phone/Fax

Practice location:
  • Phone: 707-761-1067
  • Fax:
Mailing address:
  • Phone: 707-761-1067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ISHMAEL PRUITT
Title or Position: CEO
Credential:
Phone: 707-761-1067