| Learning Dynamics, Inc. | |
|
22837 Ventura Blvd Woodland Hills CA 91364-1224 | |
| (310) 855-3276 | |
| (310) 393-9893 |
| Full Name | Learning Dynamics, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 22837 Ventura Blvd, Woodland Hills, California |
| Authorized Official Name and Position | Nicole Brown (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3108553276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Learning Dynamics, Inc. 22837 Ventura Blvd Suite 200 Woodland Hills CA 91364-1224 Ph: (310) 855-3276 | Learning Dynamics, Inc. 22837 Ventura Blvd Woodland Hills CA 91364-1224 Ph: (310) 855-3276 |
| NPI Number | 1497091045 |
|---|---|
| Provider Enumeration Date | 12/28/2012 |
| Last Update Date | 10/21/2024 |
| Certification Date | 10/21/2024 |
| Medicare PECOS PAC ID | 4981858487 |
|---|---|
| Medicare Enrollment ID | O20130211000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497091045 | NPI | - | NPPES |
| GX727A | Other | CA | MEDICARE PTAN |
| CA178403 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 251V00000X | Voluntary Or Charitable | (* (Not Available)) | Secondary |
| Provider Name | Nicole Enjoli Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518341387 PECOS PAC ID: 2062666563 Enrollment ID: I20180212002854 |
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