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Organization

ELEVATE PSYCHOLOGY AND WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOMINIQUE WHITE PHD (CEO)
(310) 564-6170
Entity
Organization

Contact information

Practice address
3608 MANHATTAN AVE, MANHATTAN BEACH, CA 90266-3234
(310) 564-6170
Mailing address
1007 N SEPULVEDA BLVD UNIT 212, MANHATTAN BEACH, CA 90267-8208
(310) 564-6170

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
10/20/2023
Last updated
10/20/2023
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