Provider Demographics
NPI:1285184838
Name:MINDFUL FOCUSED THERAPY, A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:MINDFUL FOCUSED THERAPY, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-275-1207
Mailing Address - Street 1:13351 RIVERSIDE DR # 581D
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2542
Mailing Address - Country:US
Mailing Address - Phone:818-275-1207
Mailing Address - Fax:855-276-4211
Practice Address - Street 1:13351 RIVERSIDE DR # 581D
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2542
Practice Address - Country:US
Practice Address - Phone:818-275-1207
Practice Address - Fax:855-276-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26632103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB226319OtherMEDICARE ID