Individual
SAMADRA EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1704 W MANCHESTER AVE STE 206F, LOS ANGELES, CA 90047-3057
(424) 444-8538
Mailing address
4228 W 129TH ST APT B, HAWTHORNE, CA 90250-5559
(424) 444-8598
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
—
CA
172V00000X
Community Health Worker
—
CA
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
01/12/2026
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