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General NPI Number Information
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NPI Number | 1407784648
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Entity Type | Organization
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Legal Business Name | MANDALA PSYCHE NURSING CORP
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Dates
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Enumeration Date | 05/09/2026
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Last Update Date | 05/09/2026
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Provider Practice Location Address
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Address Line | 3368 VISTA HAVEN RD
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-4920
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Country | US
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Telephone | 323-697-7381
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Fax | 855-295-6996
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Provider Business Mailing Address
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Address Line | 5630 VENICE BLVD STE 1085
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City | LOS ANGELES
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State | CA
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Zip | 90019-5127
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Country | US
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Telephone | 323-697-7381
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Fax | 855-295-6996
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Authorized Official
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Title or Position | FOUNDR/CLINICIAN
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Name | DR. TATIANA MOLINAR
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Credential | DNP, PMHNP
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Telephone | 323-697-7381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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