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General NPI Number Information
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NPI Number | 1417768722
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE AWAKENINGS PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1849 SAWTELLE BLVD STE 610
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City | LOS ANGELES
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State | CA
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Zip | 90025-7013
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Country | US
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Telephone | 530-691-0194
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Fax |
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Provider Business Mailing Address
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Address Line | 1849 SAWTELLE BLVD STE 610
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City | LOS ANGELES
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State | CA
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Zip | 90025-7013
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Country | US
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Telephone | 530-691-0193
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Fax | 310-943-2321
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICAL
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Name | JULIE ANN THERESE DE LOS SANTOS
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Credential | PMHNP-BC
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Telephone | 530-691-0194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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