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General NPI Number Information
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NPI Number | 1770398794
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Entity Type | Organization
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Legal Business Name | A HEALING GROUND
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 22231 MULHOLLAND HWY STE 107
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City | CALABASAS
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State | CA
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Zip | 91302-5151
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Country | US
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Telephone | 818-804-1284
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Fax |
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Provider Business Mailing Address
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Address Line | 21781 VENTURA BLVD STE 107
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1835
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Country | US
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Telephone | 818-725-6082
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JACQUELINE MENDDEZ
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Credential | LMFT, CST, CSTS
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Telephone | 818-804-1284
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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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