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General NPI Number Information
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NPI Number | 1871809822
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Entity Type | Organization
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Legal Business Name | EMOTIONAL WELLNESS MANAGEMENT, INC
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 468 N CAMDEN DR STE 353
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4507
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Country | US
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Telephone | 310-601-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 468 N CAMDEN DR STE 353
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4507
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Country | US
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Telephone | 301-601-3074
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Fax |
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Authorized Official
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Title or Position | CEO/MEDICAL DIRECTOR
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Name | DR. SENIORA MATTHEWS
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Credential | M.D.
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Telephone | 310-601-3074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A93922
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License Number State | CA
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