=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134935000
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE CONSCIOUSNESS CENTER, AN INDIVIDUAL, MARRIAGE, AND FAMILY HOLISTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2024
-----------------------------------------------------
Last Update Date | 01/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 65 N MADISON AVE STE 707
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91101-2046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-605-1785
-----------------------------------------------------
Fax | 626-344-2160
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8695
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92822-5695
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-605-1785
-----------------------------------------------------
Fax | 626-344-2160
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SEEMA SHARMA
-----------------------------------------------------
Credential | MA, MBA, LMFT
-----------------------------------------------------
Telephone | 626-605-1785
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------