Provider Demographics
NPI:1386450062
Name:AWESOME MENTAL HEALTH
Entity type:Organization
Organization Name:AWESOME MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:626-383-7150
Mailing Address - Street 1:3330 HARBOR BLVD
Mailing Address - Street 2:2ND FL, STE 325
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:209-755-7884
Mailing Address - Fax:626-603-1589
Practice Address - Street 1:3330 HARBOR BLVD
Practice Address - Street 2:2ND FL, STE 325
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:209-755-7884
Practice Address - Fax:626-603-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty