Active NPI
Embrace Your Healing Behavioral Health
- Psychiatric/Mental Health Nurse Practitioner
- Encino, CA
National Provider Identifier
1093466047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- 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, 2022
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 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
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Bakersfield, CA
- NPI 1811201924
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.