Serenity Trauma Healing Center Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY19847 Issued in CA

Legal business name

SERENITY TRAUMA HEALING CENTER INC

Practice address

881 Alma Real Dr Ste 218
Pacific Palisades, CA 90272-5039

Phone

(310) 310-9249

NPI assigned

Mar 11, 2013

Organization subpart

No

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

Authorized official

Name

Karol Darsa Nechushtan

Title

Co-Director

Phone

(310) 310-9249

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1114268497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR STE 218",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902725039",
            "telephone_number": "310-310-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR STE 218",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902725039",
            "telephone_number": "310-310-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY TRAUMA HEALING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-11",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "NECHUSHTAN",
        "authorized_official_first_name": "KAROL",
        "authorized_official_middle_name": "DARSA",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "310-310-9249"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.