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General NPI Number Information
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NPI Number | 1770190480
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Entity Type | Organization
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Legal Business Name | MIRAMINDS HOLISTIC CARE, INC
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Dates
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Enumeration Date | 09/26/2020
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 21515 HAWTHORNE BLVD STE 200
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City | TORRANCE
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State | CA
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Zip | 90503-6512
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Country | US
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Telephone | 844-207-8080
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Fax | 575-205-0309
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Provider Business Mailing Address
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Address Line | 15909 S ORCHARD AVE
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City | GARDENA
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State | CA
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Zip | 90247-4545
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Country | US
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Telephone | 310-770-2057
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Fax | 575-205-0309
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Authorized Official
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Title or Position | CEO
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Name | PAMELA A YUNGA
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Credential | DNP, PMHNP-BC, ACNP
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Telephone | 480-604-1042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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Taxonomy #5
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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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