Embodiment Psychology Group a Professional Corporation

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

EMBODIMENT PSYCHOLOGY GROUP A PROFESSIONAL CORPORATION

Practice address

415 N Camden Dr Ste 214
Beverly Hills, CA 90210-4439

Phone

(213) 249-0118

NPI assigned

Mar 1, 2023

Organization subpart

No

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

Authorized official

Name

Heather Laface

Title

Owner

Phone

(213) 249-0118

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1336848100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CAMDEN DR STE 214",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CAMDEN DR STE 214",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104439",
            "telephone_number": "213-249-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIMENT PSYCHOLOGY GROUP A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "LAFACE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-249-0118"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.