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NPI Code Detail

MEDICARE: WEST VALLEY WELLNESS INC

MEDICARE: WEST VALLEY WELLNESS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1558203398
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST VALLEY WELLNESS INC
Provider Business Mailing Address
First Line : 5901 W CENTURY BLVD STE 750
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5443
Country : US
Telephone Number : 818-805-6858
Fax Number :
Provider Business Practice Location Address
First Line : 5901 W CENTURY BLVD STE 750
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5443
Country : US
Telephone Number : 818-805-6858
Fax Number :
Authorized Official
Title or Position : CEO
Name : NICHOLAS KUECHENBERG
Credential :
Telephone Number : 818-805-6858
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “WEST VALLEY WELLNESS INC ” Practice Location

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