Healthcare Provider Details

I. General information

NPI: 1679485130
Provider Name (Legal Business Name): LEARNING WELLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6512 RUGBY AVE APT 212
HUNTINGTON PARK CA
90255-6960
US

IV. Provider business mailing address

6512 RUGBY AVE APT 212
HUNTINGTON PARK CA
90255-6960
US

V. Phone/Fax

Practice location:
  • Phone: 424-256-4322
  • Fax:
Mailing address:
  • Phone: 424-256-4322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHELLE MASON
Title or Position: CEO
Credential:
Phone: 424-256-4322