=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285184838
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MINDFUL FOCUSED THERAPY- A PSYCHOLOGICAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2016
-----------------------------------------------------
Last Update Date | 03/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13351 RIVERSIDE DR # 581D
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91423-2542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-275-1207
-----------------------------------------------------
Fax | 855-276-4211
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13351 RIVERSIDE DR # 581D
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91423-2542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-275-1207
-----------------------------------------------------
Fax | 855-276-4211
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOLOGIST
-----------------------------------------------------
Name | DR. ANA L OCHOA
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 818-275-1207
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | PSY26632
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------