=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851238018
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMOTIVA HEALTHCARE NURSING CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2600 W OLIVE AVE FL 5
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91505-4572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-934-4505
-----------------------------------------------------
Fax | 747-200-1307
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2600 W OLIVE AVE
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91505-4549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-906-8973
-----------------------------------------------------
Fax | 747-200-1307
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COFOUNDER
-----------------------------------------------------
Name | AHMAD QUDAIESAT
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 310-906-8973
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------