Provider Demographics
NPI:1225916901
Name:HOLISTICALLY YOU MENTAL WELLNESS SERVICES
Entity type:Organization
Organization Name:HOLISTICALLY YOU MENTAL WELLNESS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:213-835-4815
Mailing Address - Street 1:6415 POLLARD ST APT 9
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2856
Mailing Address - Country:US
Mailing Address - Phone:240-210-6479
Mailing Address - Fax:
Practice Address - Street 1:6415 POLLARD ST APT 9
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-2856
Practice Address - Country:US
Practice Address - Phone:240-210-6479
Practice Address - Fax:213-835-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty