# PRIDE PSYCHIATRY SERVICES

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

## Provider details

- **NPI number:** 1669298527
- **Authorized official:** MR. ADILSON KIEFER APRN (APRN)
- **Authorized official phone:** (818) 736-8642

## Contact information

- **Practice address:** 15720 VENTURA BLVD STE 528, ENCINO, CA 91436-2936
- **Practice address phone:** (818) 736-8642
- **Mailing address:** 15720 VENTURA BLVD STE 528, ENCINO, CA 91436-2936
- **Mailing address phone:** (818) 736-8642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | — |
| 2084P0805X | Geriatric Psychiatry Physician | — | NULL | — |
| 2084P0805X | Geriatric Psychiatry Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/25/2024
- **Last updated:** 11/25/2024