Provider Demographics
NPI:1073202164
Name:FLOW WELLNESS AND PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:FLOW WELLNESS AND PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-255-0357
Mailing Address - Street 1:9920 PACIFIC HEIGHTS BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4361
Mailing Address - Country:US
Mailing Address - Phone:858-255-0357
Mailing Address - Fax:
Practice Address - Street 1:9920 PACIFIC HEIGHTS BLVD STE 150
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4361
Practice Address - Country:US
Practice Address - Phone:858-255-0357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1639378714Medicaid