MEDICARE: CEOME LLC

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1912850744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEOME LLC

Provider Business Mailing Address
First Line	:	4452 GALLOP CT
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92545-7305
Country	:	US
Telephone Number	:	310-885-1409
Fax Number	:	310-885-1409

Provider Business Practice Location Address
First Line	:	4452 GALLOP CT
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92545-7305
Country	:	US
Telephone Number	:	310-885-1409
Fax Number	:	310-885-1409

Authorized Official
Title or Position	:	LMFT
Name	:	JAMILA BANKS
Credential	:
Telephone Number	:	310-885-1409

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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Directions to “CEOME LLC ” Practice Location

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