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General NPI Number Information
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NPI Number | 1356955595
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Entity Type | Organization
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Legal Business Name | EXPRESS HEALTHCARE LLC
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 21839 SADDLE PEAK ROAD
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City | TOPANGA
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State | CA
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Zip | 90290
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Country | US
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Telephone | 668-866-1466
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Fax |
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Provider Business Mailing Address
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Address Line | 14320 VENTURA BLVD # 434
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2717
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Country | US
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Telephone | 668-866-1466
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL BROOKS
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Credential |
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Telephone | 866-866-1466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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