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General NPI Number Information
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NPI Number | 1558679696
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Entity Type | Organization
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Legal Business Name | NOVUS MINDFUL LIFE INSTITUTE
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 6695 E PACIFIC COAST HWY SUITE 135
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City | LONG BEACH
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State | CA
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Zip | 90803-4203
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Country | US
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Telephone | 562-431-5100
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Fax | 562-431-3560
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Provider Business Mailing Address
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Address Line | 6695 E PACIFIC COAST HWY SUITE 135
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City | LONG BEACH
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State | CA
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Zip | 90803-4203
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Country | US
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Telephone | 562-431-5100
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Fax | 562-431-3560
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DANIELLE M OSTERLIND
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Credential |
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Telephone | 562-822-5699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20813
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 44567
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License Number State | CA
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