| Mindful Living Center, Llc | |
|
10737 Gateway Blvd W Ste 204 El Paso TX 79935-4910 | |
| (915) 286-6370 | |
| Not Available |
| Full Name | Mindful Living Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10737 Gateway Blvd W Ste 204, El Paso, Texas |
| Authorized Official Name and Position | Erik Tolonen (VP) |
| Authorized Official Contact | 3235809477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Living Center, Llc 215 Huntington Irvine CA 92620-5736 Ph: (323) 419-3869 | Mindful Living Center, Llc 10737 Gateway Blvd W Ste 204 El Paso TX 79935-4910 Ph: (915) 286-6370 |
| NPI Number | 1962028050 |
|---|---|
| Provider Enumeration Date | 06/24/2020 |
| Last Update Date | 02/01/2024 |
| Certification Date | 02/01/2024 |
| Medicare PECOS PAC ID | 8224437082 |
|---|---|
| Medicare Enrollment ID | O20210527000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962028050 | NPI | - | NPPES |
| Provider Name | Martin Guerrero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952591935 PECOS PAC ID: 6002894094 Enrollment ID: I20040707001203 |
| Provider Name | Tahir Nisar Khwaja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881804938 PECOS PAC ID: 5092844928 Enrollment ID: I20200316000816 |
| Provider Name | Anastasia Zacour |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902406820 PECOS PAC ID: 9436536521 Enrollment ID: I20220511000091 |
| Provider Name | Jennifer Paniagua |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245981125 PECOS PAC ID: 1052799806 Enrollment ID: I20220607000854 |
| Provider Name | Tiffany Wilkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992434534 PECOS PAC ID: 9830578020 Enrollment ID: I20220617001466 |
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