NPIMap

Organization Active NPI

Bespoke Professional Services

  • Adult Mental Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1376258244
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BESPOKE PROFESSIONAL SERVICES
Practice address
12381 Wilshire Blvd BLDG Ste 205
Los Angeles, CA 90025-1063
Phone
(833) 867-2329
Fax
(833) 867-3757
NPI assigned
Jan 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Ms. Thi Hoang
Title
Business Office Advoctae
Phone
(702) 205-8232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

12381 Wilshire Blvd BLDG Ste 205
Los Angeles, CA 90025-1063

Mailing address

12381 Wilshire Blvd BLDG Ste 205
Los Angeles, CA 90025-1063
Phone (833) 867-2329

Other names 1

  • Bespoke Professional Services, a Physician Assistant Corporation Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1376258244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12381 WILSHIRE BLVD BLDG STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251063",
            "telephone_number": "833-867-2329",
            "fax_number": "833-867-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 WILSHIRE BLVD BLDG STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251063",
            "telephone_number": "833-867-2329",
            "fax_number": "833-867-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "THI",
        "authorized_official_title_or_position": "BUSINESS OFFICE ADVOCTAE",
        "authorized_official_telephone_number": "702-205-8232",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bespoke Professional Services, a Physician Assistant Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.