Healthcare Provider Details

I. General information

NPI: 1770447732
Provider Name (Legal Business Name): WELLNESS IN MOTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

894 PHILLIPS ST
VISTA CA
92083-7162
US

IV. Provider business mailing address

894 PHILLIPS ST
VISTA CA
92083-7162
US

V. Phone/Fax

Practice location:
  • Phone: 475-316-9118
  • Fax:
Mailing address:
  • Phone: 475-316-9118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MALACHI WILLIAMS
Title or Position: OWNER
Credential:
Phone: 475-316-9118