Healthcare Provider Details

I. General information

NPI: 1386575009
Provider Name (Legal Business Name): THE NATURAL STATE WELLNESS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 S MILLER ST STE G
SANTA MARIA CA
93454-6962
US

IV. Provider business mailing address

1635 HIGDON FERRY RD STE C
HOT SPRINGS NATIONAL PARK AR
71913-6904
US

V. Phone/Fax

Practice location:
  • Phone: 760-459-9790
  • Fax:
Mailing address:
  • Phone: 760-459-9790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARTENA R WILSON
Title or Position: CEO
Credential:
Phone: 760-459-9790