Healthcare Provider Details

I. General information

NPI: 1205811122
Provider Name (Legal Business Name): THE WHOLE WOMAN, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 SYCAMORE DR SUITE #201
SIMI VALLEY CA
93065-1210
US

IV. Provider business mailing address

2950 SYCAMORE DR SUITE #201
SIMI VALLEY CA
93065-1210
US

V. Phone/Fax

Practice location:
  • Phone: 805-584-7092
  • Fax: 805-584-7096
Mailing address:
  • Phone: 805-584-7092
  • Fax: 805-584-7096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License NumberMIDWIFE #134
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License NumberNP 429440
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License NumberFURNISHING 9578
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberFURNISHING 9578
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberFURNISHING 9578
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberDEA# MM0542476
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP 429440
License Number StateCA
# 8
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNP 429440
License Number StateCA

VIII. Authorized Official

Name: MARCIA KAY MCCULLEY
Title or Position: OWNER/CEO
Credential: N.P., LM
Phone: 805-584-7092