Healthcare Provider Details

I. General information

NPI: 1225932767
Provider Name (Legal Business Name): ANIMA WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 VICENTE SOUTH BAZA STREET
YONA GU
96915
US

IV. Provider business mailing address

117 SABANA LN
YONA GU
96915-4917
US

V. Phone/Fax

Practice location:
  • Phone: 671-789-0627
  • Fax:
Mailing address:
  • Phone: 671-687-8079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: THERESA RIVERA
Title or Position: OWNER/ MASSAGE THERAPIST
Credential:
Phone: 671-687-8079