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General NPI Number Information
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NPI Number | 1700315199
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Entity Type | Organization
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Legal Business Name | POSITIVE IMAGERY FOUNDATION
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5906 7TH AVENUE SUITE 1
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City | LOS ANGELES
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State | CA
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Zip | 90043
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Country | US
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Telephone | 323-294-9300
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Fax | 323-294-9360
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Provider Business Mailing Address
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Address Line | 5906 7TH AVE STE 1
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City | LOS ANGELES
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State | CA
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Zip | 90043-3204
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Country | US
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Telephone | 323-294-9300
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Fax | 323-294-9360
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. RONALD BEAVERS
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Credential | PH.D.
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Telephone | 323-294-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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