Healthcare Provider Details

I. General information

NPI: 1083529424
Provider Name (Legal Business Name): INTEGRATIVE WELLNESS PSYCHIATRIC CARE, NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 W MANCHESTER BLVD STE 101
INGLEWOOD CA
90301-1680
US

IV. Provider business mailing address

614 W MANCHESTER BLVD STE 101
INGLEWOOD CA
90301-1680
US

V. Phone/Fax

Practice location:
  • Phone: 323-833-5602
  • Fax:
Mailing address:
  • Phone: 323-833-5602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAWANDA SMITH
Title or Position: PRESIDENT
Credential: RN, NP
Phone: 323-833-5062