Healthcare Provider Details

I. General information

NPI: 1912703638
Provider Name (Legal Business Name): SATYA SOL FAMILY WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2025
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 W MAGNOLIA ST
STOCKTON CA
95203-2333
US

IV. Provider business mailing address

619 W MAGNOLIA ST
STOCKTON CA
95203-2333
US

V. Phone/Fax

Practice location:
  • Phone: 209-787-9420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: IRIE WOODS
Title or Position: OWNER
Credential:
Phone: 209-787-9420