Healthcare Provider Details

I. General information

NPI: 1295654606
Provider Name (Legal Business Name): ROOTED IN WELLNESS MENTAL HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W DUNNE AVE
MORGAN HILL CA
95037-4716
US

IV. Provider business mailing address

409 TENNANT STA PMB 548
MORGAN HILL CA
95037-7115
US

V. Phone/Fax

Practice location:
  • Phone: 408-539-9155
  • Fax: 650-412-8529
Mailing address:
  • Phone: 408-539-9155
  • Fax: 650-412-8529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHUNICHI LASHAWN DAVID
Title or Position: PRESIDENT
Credential: PMHNP-BC
Phone: 408-539-9155