Provider Demographics
NPI:1558934877
Name:EVER LASTING POSITIVE CHANGE, INC.
Entity Type:Organization
Organization Name:EVER LASTING POSITIVE CHANGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARAREH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMJOO
Authorized Official - Suffix:
Authorized Official - Credentials:DR OF PSYCHOLOGY
Authorized Official - Phone:562-787-6137
Mailing Address - Street 1:4231 LARWIN AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-4147
Mailing Address - Country:US
Mailing Address - Phone:562-787-6137
Mailing Address - Fax:
Practice Address - Street 1:4231 LARWIN AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-4147
Practice Address - Country:US
Practice Address - Phone:562-787-6137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty