Healthcare Provider Details
I. General information
NPI: 1811211741
Provider Name (Legal Business Name): AMERICAN HEALTH AND WELLNESS INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2010
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5580 E 2ND ST SUITE 101
LONG BEACH CA
90803-3946
US
IV. Provider business mailing address
5580 E 2ND ST SUITE 101
LONG BEACH CA
90803-3946
US
V. Phone/Fax
- Phone: 562-375-0451
- Fax: 562-433-5522
- Phone: 562-375-0451
- Fax: 562-433-5522
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 0810001495 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 23144 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | 0810001495 |
| License Number State | VA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | 23144 |
| License Number State | CA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | PSY003323 |
| License Number State | GA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 23144 |
| License Number State | CA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY003323 |
| License Number State | GA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | 0810001495 |
| License Number State | VA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | 23144 |
| License Number State | CA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 12861 |
| License Number State | CA |
| # 11 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 0810001495 |
| License Number State | VA |
VIII. Authorized Official
Name: DR.
ASHVIND
N
ADKINS SINGH
Title or Position: CHIEF CLINICAL MANAGER
Credential: PHD
Phone: 562-375-0451