Healthcare Provider Details

I. General information

NPI: 1770105595
Provider Name (Legal Business Name): CRISISRESOLVE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12001 VENTURA PL STE 203
STUDIO CITY CA
91604-2628
US

IV. Provider business mailing address

12001 VENTURA PL STE 203
STUDIO CITY CA
91604-2628
US

V. Phone/Fax

Practice location:
  • Phone: 818-395-7440
  • Fax: 213-403-4201
Mailing address:
  • Phone: 818-395-7440
  • Fax: 213-403-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA ROY
Title or Position: CEO
Credential: PHD
Phone: 818-691-2591