| Organization Name: | SERENITY TRAUMA HEALING CENTER INC |
| NPI Number: | 1114268497 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAROL DARSA NECHUSHTAN (CO-DIRECTOR) |
| Mailing Address: | 881 Alma Real Dr Ste 218 Pacific Palisades |
| State: | CA US |
| Postal Code: | 902725039 |
| Phone Number: | 3103109249 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2013 |
| NPI Last Update Date: | 03/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY19847 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |