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General NPI Number Information
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NPI Number | 1154200475
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Entity Type | Organization
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Legal Business Name | ELEVE CONCIERGE WELLNESS, A PROFESSIOINAL NURSING CORPORATION
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 916 STONEHILL LN
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City | LOS ANGELES
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State | CA
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Zip | 90049-1413
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Country | US
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Telephone | 310-633-1907
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Fax | 310-633-1907
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Provider Business Mailing Address
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Address Line | 916 STONEHILL LN
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City | LOS ANGELES
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State | CA
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Zip | 90049-1413
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Country | US
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Telephone | 310-633-1907
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Fax | 310-633-1907
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Authorized Official
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Title or Position | CEO
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Name | CAITLIN ROSE BOTHWELL
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Credential |
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Telephone | 310-633-1907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State | NULL
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