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General NPI Number Information
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NPI Number | 1386450062
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Entity Type | Organization
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Legal Business Name | AWESOME MENTAL HEALTH
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 3330 HARBOR BLVD 2ND FL, STE 325
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City | COSTA MESA
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State | CA
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Zip | 92626
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Country | US
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Telephone | 209-755-7884
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Fax | 626-603-1589
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Provider Business Mailing Address
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Address Line | 3330 HARBOR BLVD 2ND FL, STE 325
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City | COSTA MESA
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State | CA
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Zip | 92626
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Country | US
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Telephone | 209-755-7884
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Fax | 626-603-1589
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Authorized Official
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Title or Position | CEO
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Name | TINA FRANCIS CHEN
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Credential | PMHNP
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Telephone | 626-383-7150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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