Healthcare Provider Details

I. General information

NPI: 1477471332
Provider Name (Legal Business Name): JBI WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2928 GAVIOTA CIR
CARLSBAD CA
92009-8216
US

IV. Provider business mailing address

3142 VISTA WAY STE 207
OCEANSIDE CA
92056-3628
US

V. Phone/Fax

Practice location:
  • Phone: 516-650-9240
  • Fax:
Mailing address:
  • Phone: 516-650-9240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH HEAPHY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 516-650-9240