Basic Information
| Provider Information | |||||||||
| NPI: | 1679136634 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALING RHYTHMS PSYCHOLOGICAL SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 521 1/2 S MYRTLE AVE STE 9 | ||||||||
| Address2: | |||||||||
| City: | MONROVIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910165131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269408670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 521 1/2 S MYRTLE AVE STE 9&10 | ||||||||
| Address2: | |||||||||
| City: | MONROVIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910165189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269408670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2019 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| AuthorizedOfficialLastName: | KAO | ||||||||
| AuthorizedOfficialFirstName: | WAYNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6269406744 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 103TC0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.