Healthcare Provider Details

I. General information

NPI: 1649920364
Provider Name (Legal Business Name): CLEAR PATH WELLNESS LOUNGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 E COLORADO BLVD APT 1607
PASADENA CA
91101-2257
US

IV. Provider business mailing address

16694 GOLFVIEW DR
WESTON FL
33326-1812
US

V. Phone/Fax

Practice location:
  • Phone: 754-294-4357
  • Fax:
Mailing address:
  • Phone: 954-336-3948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. TANIA GUERRIER CASTOR
Title or Position: OWNER
Credential: APRN
Phone: 954-851-4042