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General NPI Number Information
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NPI Number | 1104601624
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR WHOLENESS
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 6056 PASEO PRADERA
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City | CARLSBAD
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State | CA
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Zip | 92009-2241
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Country | US
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Telephone | 760-579-8037
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 BUSINESS PARK DR. STE C #240
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City | VISTA
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State | CA
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Zip | 92081-8532
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Country | US
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Telephone | 760-579-8037
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Fax |
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Authorized Official
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Title or Position | DIRECTOR EMERITUS
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Name | JANINE C STOCK
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Credential | LMFT
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Telephone | 760-271-1812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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