Healthcare Provider Details

I. General information

NPI: 1760602965
Provider Name (Legal Business Name): BE WELL NOW INSTITUTE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20710 LEAPWOOD AVE STE. C
CARSON CA
90746-3642
US

IV. Provider business mailing address

20710 LEAPWOOD AVE STE. C
CARSON CA
90746-3642
US

V. Phone/Fax

Practice location:
  • Phone: 310-324-0447
  • Fax: 310-324-0147
Mailing address:
  • Phone: 310-324-0447
  • Fax: 310-324-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW MICHAEL VELASQUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 310-324-0447