Healthcare Provider Details

I. General information

NPI: 1659956555
Provider Name (Legal Business Name): RILLIE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19100 VENTURA BLVD STE 11
TARZANA CA
91356-3234
US

IV. Provider business mailing address

19100 VENTURA BLVD STE 11
TARZANA CA
91356-3234
US

V. Phone/Fax

Practice location:
  • Phone: 310-571-5957
  • Fax:
Mailing address:
  • Phone: 310-571-5957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RISHI KHATRI
Title or Position: MANAGER
Credential:
Phone: 310-571-5957