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5900 S Eastern Ave Ste 142 Commerce CA 90040-4024 | |
| (323) 278-6501 | |
| (323) 278-6515 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 5900 S Eastern Ave Ste 142, Commerce, California |
| Authorized Official Name and Position | Kimberly Smoak Berry (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3232786501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5900 S Eastern Ave Ste 186 Commerce CA 90040-4018 Ph: (323) 278-6501 | 5900 S Eastern Ave Ste 142 Commerce CA 90040-4024 Ph: (323) 278-6501 |
| NPI Number | 1154605939 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 02/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154605939 | NPI | - | NPPES |
| 7429 | Other | CA | DRUG MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (California) | Primary |
Conscious Culture Psychology Clinic Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5800 S Eastern Ave, Commerce, CA 90040 Phone: 626-430-4521 Fax: 626-498-1483 | |
Penny Lane Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2450 S Atlantic Blvd Ste 101, Commerce, CA 90040 Phone: 323-318-9960 Fax: 323-780-3211 | |