MEDICARE: AJC INNOVATIVE CONSULTING FOR 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1942198072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJC INNOVATIVE CONSULTING FOR WELLNESS INC

Provider Business Mailing Address
First Line	:	13001 SEAL BEACH BLVD STE 360
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2747
Country	:	US
Telephone Number	:	562-480-3001
Fax Number	:

Provider Business Practice Location Address
First Line	:	13001 SEAL BEACH BLVD STE 360
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2747
Country	:	US
Telephone Number	:	562-480-3001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ANGELA JEANETH CASTELLANOS
Credential	:	LCSW
Telephone Number	:	562-480-3001

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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