# SOCAL BEHAVIORAL MEDICINE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SoCal Behavioral Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134691124
- **Authorized official:** GINGER HULST NP (CO-OWNER)
- **Authorized official phone:** (310) 698-5252

## Contact information

- **Practice address:** 1611 S PACIFIC COAST HWY STE 200D, REDONDO BEACH, CA 90277-5611
- **Practice address phone:** (310) 698-5252
- **Mailing address:** 10650 REAGAN ST UNIT 824, LOS ALAMITOS, CA 90720-8844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0000X | Pain Management Registered Nurse | — | NULL | — |
| 163WP0000X | Pain Management Registered Nurse | — | — | — |
| 163WP0809X | Adult Psychiatric/Mental Health Registered Nurse | — | — | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/01/2019
- **Last updated:** 03/24/2026