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General NPI Number Information
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NPI Number | 1023987013
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Entity Type | Organization
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Legal Business Name | SB WELLNESS, LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 8899 UNIVERSITY CENTER LN STE 240
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City | SAN DIEGO
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State | CA
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Zip | 92122-1039
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Country | US
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Telephone | 619-880-6603
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Fax |
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Provider Business Mailing Address
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Address Line | 9984 SCRIPPS RANCH BLVD UNIT 960
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City | SAN DIEGO
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State | CA
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Zip | 92131-1825
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Country | US
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Telephone | 619-880-6603
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC, OWNER
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Name | NICOLE SANTOS
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Credential | NP
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Telephone | 619-395-6499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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