Organization
WAVEMIND INC, A PSYCHOLOGY CORPORATION
Active
Other names
WaveMind Clinic, MindBloom Inc, A Psychology Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLE CORNACCHIO PHD (LICENSED PSYCHOLOGIST, OWNER)
(914) 275-5578
Entity
Organization
Contact information
Practice address
1849 SAWTELLE BLVD STE 610, LOS ANGELES, CA 90025-7013
(914) 275-5578
Mailing address
1849 SAWTELLE BLVD STE 610, LOS ANGELES, CA 90025-7013
(914) 275-5578
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396486023
DR. ANNA ALKOZEI
CA
01
—
1528093820
DR. RONNIE LINDSEY BERGMAN
CA
Enumeration date
02/09/2021
Last updated
05/19/2023
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