| Ellen Mental Health Inc | |
|
5626 Sultana Ave Apt 3 Temple City CA 91780-2374 | |
| (626) 827-0418 | |
| Not Available |
| Full Name | Ellen Mental Health Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 5626 Sultana Ave Apt 3, Temple City, California |
| Authorized Official Name and Position | Wylma Gibbs (MARRIAGE FAMILY THERAPIST) |
| Authorized Official Contact | 6268270418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Mental Health Inc 5626 Sultana Ave Apt 3 Temple City CA 91780-2374 Ph: (626) 827-0418 | Ellen Mental Health Inc 5626 Sultana Ave Apt 3 Temple City CA 91780-2374 Ph: (626) 827-0418 |
| NPI Number | 1992201974 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 03/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992201974 | NPI | - | NPPES |
| 1295867901 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC49020 (California) | Primary |
Sgv Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9602 Las Tunas Dr Ste 202, Temple City, CA 91780 Phone: 626-537-9775 |