Healthcare Provider Details

I. General information

NPI: 1548125958
Provider Name (Legal Business Name): WHOLISTIC SOUL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3646 LONG BEACH BLVD STE 202
LONG BEACH CA
90807-4087
US

IV. Provider business mailing address

3515 ATLANTIC AVE # 1068
LONG BEACH CA
90807-4515
US

V. Phone/Fax

Practice location:
  • Phone: 562-247-4752
  • Fax:
Mailing address:
  • Phone: 562-247-4752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. TIFFANY FELIX
Title or Position: FOUNDER/PRESIDENT
Credential:
Phone: 562-239-7006