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Organization
MAVIDA CARE GROUP OF CALIFORNIA PC
Active
Organization
MAVIDA CARE GROUP OF CALIFORNIA PC
Active
Other names
Mavida Health Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH ORECK MD (CEO)
(818) 590-1369
Entity
Organization
Contact information
Practice address
11911 SAN VICENTE BLVD STE 280, LOS ANGELES, CA 90049-6611
(818) 590-1369
Mailing address
5120 WOODLEY AVE, ENCINO, CA 91436-1443
(818) 554-0322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215356118
—
CA
Enumeration date
07/31/2023
Last updated
07/31/2023
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