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General NPI Number Information
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NPI Number | 1619393816
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Entity Type | Organization
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Legal Business Name | FIT METHOD, INC.
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 06/11/2015
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Provider Practice Location Address
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Address Line | 12011 SAN VICENTE BLVD STE 510 SUITE 510
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City | LOS ANGELES
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State | CA
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Zip | 90049-4947
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Country | US
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Telephone | 866-244-8269
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Fax |
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Provider Business Mailing Address
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Address Line | 12011 SAN VICENTE BLVD SUITE 510
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City | LOS ANGELES
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State | CA
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Zip | 90049-4926
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SHEILA SHILATI
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Credential | PSY.D.
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Telephone | 866-244-8269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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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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