Healthcare Provider Details

I. General information

NPI: 1144684721
Provider Name (Legal Business Name): ENKI HEALTH SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 W WEST COVINA PKWY
WEST COVINA CA
91790-2946
US

IV. Provider business mailing address

150 E OLIVE AVE #203
BURBANK CA
91502-1846
US

V. Phone/Fax

Practice location:
  • Phone: 626-974-0770
  • Fax: 626-974-0774
Mailing address:
  • Phone: 818-973-4899
  • Fax: 818-973-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SARA SERRANO
Title or Position: COS
Credential:
Phone: 818-973-4899