# MINDSPACE NP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316728579
- **Authorized official:** TANG SHAOQING PMHNP (OWNER)
- **Authorized official phone:** (747) 227-7593

## Contact information

- **Practice address:** 16530 VENTURA BLVD STE 400, ENCINO, CA 91436-4551
- **Practice address phone:** (747) 227-7593
- **Mailing address:** 16530 VENTURA BLVD, ENCINO, CA 91436-4554
- **Mailing address phone:** (747) 227-7593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2023
- **Last updated:** 11/13/2025