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General NPI Number Information
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NPI Number | 1023465317
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Entity Type | Organization
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Legal Business Name | SATI WELLLNESS, LLC
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 16055 VENTURA BLVD SUITE 712
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City | ENCINO
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State | CA
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Zip | 91436-2601
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Country | US
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Telephone | 818-386-1395
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Fax | 888-882-6061
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Provider Business Mailing Address
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Address Line | 16055 VENTURA BLVD SUITE 712
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City | ENCINO
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State | CA
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Zip | 91436-2601
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Country | US
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Telephone | 818-386-1395
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Fax | 888-882-6061
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Authorized Official
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Title or Position | COO
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Name | CARRIE ELIZABETH WILSON FRIEDMAN
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Credential | FNP
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Telephone | 310-779-6486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 95001868
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License Number State | CA
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