Healthcare Provider Details

I. General information

NPI: 1235084229
Provider Name (Legal Business Name): ABUNDANT WELLNESS RESIDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22737 HAMLIN ST
WEST HILLS CA
91307-3605
US

IV. Provider business mailing address

22737 HAMLIN ST
WEST HILLS CA
91307-3605
US

V. Phone/Fax

Practice location:
  • Phone: 747-230-4474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: TRIXIE GUILLERGAN
Title or Position: OWNER
Credential:
Phone: 818-854-1178