Organization Active NPI

Embrace Your Healing Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Encino, CA
National Provider Identifier
1093466047
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
EMBRACE YOUR HEALING BEHAVIORAL HEALTH
Practice address
15720 Ventura Blvd Ste 609
Encino, CA 91436-4733
Phone
(833) 736-2722
NPI assigned
Jan 11, 2022
Last updated
Feb 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandi Dawn Tilmon, RADT, MA
Title
Sud/Credentialing Manager
Phone
(661) 246-5122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

15720 Ventura Blvd Ste 609
Encino, CA 91436-4733

Mailing address

15720 Ventura Blvd Ste 609
Encino, CA 91436-4733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220420002586 CA Part B Supplier - Clinic/Group Practice 2668869736 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1093466047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD STE 609",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD STE 609",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364733",
            "telephone_number": "833-736-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRACE YOUR HEALING BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "TILMON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "SUD/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "661-246-5122",
        "authorized_official_credential": "RADT, MA"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.