Healthcare Provider Details

I. General information

NPI: 1083277677
Provider Name (Legal Business Name): WELLOCITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 SANTANA ROW 318
SAN JOSE CA
95128
US

IV. Provider business mailing address

334 SANTANA ROW 318
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 888-660-8371
  • Fax:
Mailing address:
  • Phone: 888-660-8371
  • 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: SAMEER KANAGALA
Title or Position: CEO
Credential:
Phone: 650-933-0951