Organization
CUCUMBER WELLNESS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE GENEN MD (OWNER)
(833) 427-3566
Entity
Organization
Contact information
Practice address
5201 GREAT AMERICA PKWY STE 320, SANTA CLARA, CA 95054-1140
(833) 427-3566
Mailing address
12301 WILSHIRE BLVD STE 512, LOS ANGELES, CA 90025-1021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
04/18/2020
Last updated
04/18/2020
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