Organization
STAND INBALANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALLERIE COLEMAN PH.D. (CEO)
(818) 714-1740
Entity
Organization
Contact information
Practice address
5655 LINDERO CANYON RD STE 726, WESTLAKE VILLAGE, CA 91362-4068
(818) 714-1740
Mailing address
425 W CARLISLE RD, THOUSAND OAKS, CA 91361-5314
(310) 367-2592
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY12592
CA
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962629899
—
CA
Enumeration date
07/25/2018
Last updated
08/25/2021
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