MEDICARE: CORTICA CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1053243261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORTICA CARE

Provider Business Mailing Address
First Line	:	21515 HAWTHORNE BLVD UNIT GL-100
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-6501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21515 HAWTHORNE BLVD UNIT GL-100
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-6501
Country	:	US
Telephone Number	:	424-571-2618
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIOR INTERVENTIONIST
Name	:	KRISTIAN TELLEZ
Credential	:	MASTERS
Telephone Number	:	310-941-9277

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

Similar Medicare Providers

1649599622 — MS. DIANE HAZEYAMA M.S.
Practice Location Address:

21515 HAWTHORNE BLVD
TORRANCE, CA
90503-6501

Practice Phone: 510-345-4379
Practice Fax:

1760827646 — DR. RISHIKESH MALLA M.D.
Practice Location Address:

21515 HAWTHORNE BLVD
TORRANCE, CA
90503-6501

Practice Phone: 424-571-2618
Practice Fax:

1417365248 — JODIE VICTOR M.S., CCC-SLP
Practice Location Address:

21515 HAWTHORNE BLVD STE GL-100
TORRANCE, CA
90503-6501

Practice Phone: 424-571-2618
Practice Fax:

1760923320 — MEDIATION - COUNSELING
Practice Location Address:

21515 HAWTHORNE BLVD , SUITE 1025
TORRANCE, CA
90503-6501

Practice Phone: 310-540-9128
Practice Fax:

1124553029 — REGENERATION HEALTH, INC.
Practice Location Address:

21515 HAWTHORNE BLVD , SUITE 200
TORRANCE, CA
90503-6501

Practice Phone: 206-330-6054
Practice Fax:

1578038584 — CLARENCE LUMANSOC LLOREN
Practice Location Address:

21515 HAWTHORNE BLVD STE GL-100
TORRANCE, CA
90503-6501

Practice Phone: 424-571-2618
Practice Fax:

Directions to “CORTICA CARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.