| Vivid Minds Therapy Llc | |
|
1630 W Gage Ave Fullerton CA 92833-4526 | |
| (714) 598-7204 | |
| (714) 586-5161 |
| Full Name | Vivid Minds Therapy Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1630 W Gage Ave, Fullerton, California |
| Authorized Official Name and Position | Silvia Gutierrez (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 7145987204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivid Minds Therapy Llc 1630 W Gage Ave Fullerton CA 92833-4526 Ph: (714) 598-7204 | Vivid Minds Therapy Llc 1630 W Gage Ave Fullerton CA 92833-4526 Ph: (714) 598-7204 |
| NPI Number | 1811659428 |
|---|---|
| Provider Enumeration Date | 10/11/2021 |
| Last Update Date | 10/11/2021 |
| Certification Date | 10/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811659428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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