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General NPI Number Information
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NPI Number | 1104754605
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Entity Type | Organization
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Legal Business Name | NEEMABLOOM THERAPY
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 5665 WILSHIRE BLVD STE 1210
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City | LOS ANGELES
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State | CA
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Zip | 90036-3710
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Country | US
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Telephone | 323-489-0205
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Fax |
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Provider Business Mailing Address
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Address Line | 3806 LORADO WAY 3806 LORADO WAY
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City | VIEW PARK
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State | CA
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Zip | 90043-1626
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Country | US
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Telephone | 323-489-0205
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | KELLY WALKER
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Credential | LCSW
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Telephone | 323-489-0205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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