Healthcare Provider Details

I. General information

NPI: 1477468551
Provider Name (Legal Business Name): WILDFLOWER TELEHEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 ARIA PL
SANTA ROSA CA
95403-7632
US

IV. Provider business mailing address

2443 FILLMORE ST # 380-6499
SAN FRANCISCO CA
94115-1814
US

V. Phone/Fax

Practice location:
  • Phone: 650-864-4320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: NASH PRINCE
Title or Position: CHIEF STRATEGY OFFICER
Credential:
Phone: 516-480-9100