MEDICARE: SOUNDMIND 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1821879917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUNDMIND CARE

Provider Business Mailing Address
First Line	:	16117 COLUMBUS LN
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-2160
Country	:	US
Telephone Number	:	818-900-3573
Fax Number	:	747-237-3305

Provider Business Practice Location Address
First Line	:	113 N SAN VICENTE BLVD STE 268
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2329
Country	:	US
Telephone Number	:	747-732-4549
Fax Number	:	747-237-3305

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	ELIZABETH LEMFEYIN WISIY TATA-ACHA
Credential	:	NP
Telephone Number	:	818-900-3573

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	11/07/2023

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Directions to “SOUNDMIND CARE ” Practice Location

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