Healthcare Provider Details

I. General information

NPI: 1609689611
Provider Name (Legal Business Name): MINDFULOUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 N NORMA ST
RIDGECREST CA
93555-2510
US

IV. Provider business mailing address

2021 FILLMORE ST # 2142
SAN FRANCISCO CA
94115-2708
US

V. Phone/Fax

Practice location:
  • Phone: 415-372-0892
  • Fax: 866-305-3569
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HANI CHAABO
Title or Position: CHIEF OPERATING OFFICER
Credential: MD
Phone: 415-375-0892