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General NPI Number Information
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NPI Number | 1063073583
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Entity Type | Organization
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Legal Business Name | MINDING YOUR BODY
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 250 BEL MARIN KEYS BOULEVARD SUITE D1
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City | NEVATO
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State | CA
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Zip | 94949
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Country | US
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Telephone | 707-409-0852
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 FILLMORE ST # 380-1019
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1814
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Country | US
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Telephone | 707-409-0852
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHELL TORRES
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Credential | LCSW
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Telephone | 510-747-8006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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