| Mineset Mental Health Inc. | |
|
1840 S Elena Ave Ste 106 Redondo Beach CA 90277-5716 | |
| (310) 737-2210 | |
| Not Available |
| Full Name | Mineset Mental Health Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1840 S Elena Ave Ste 106, Redondo Beach, California |
| Authorized Official Name and Position | Kimberly Ruth Nicolson (FOUNDER/PRACTITIONER) |
| Authorized Official Contact | 3107372210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mineset Mental Health Inc. 1840 S Elena Ave Ste 106 Redondo Beach CA 90277-5716 Ph: (310) 737-2210 | Mineset Mental Health Inc. 1840 S Elena Ave Ste 106 Redondo Beach CA 90277-5716 Ph: (310) 737-2210 |
| NPI Number | 1972284669 |
|---|---|
| Provider Enumeration Date | 07/26/2023 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Medicare PECOS PAC ID | 9436687951 |
|---|---|
| Medicare Enrollment ID | O20250113000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972284669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kimberly Ruth Nicolson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164617015 PECOS PAC ID: 2860867629 Enrollment ID: I20230407001779 |
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