Healthcare Provider Details

I. General information

NPI: 1245148030
Provider Name (Legal Business Name): CHARMONY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41663 DATE ST STE 101B
MURRIETA CA
92562-7078
US

IV. Provider business mailing address

PO BOX 122
FALLBROOK CA
92088-0122
US

V. Phone/Fax

Practice location:
  • Phone: 951-440-4083
  • Fax:
Mailing address:
  • Phone: 951-226-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: DR. AGAEZI SONYA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 951-440-4083