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1154234342 NPI number — EMPOWER WELLNESS CLINIC, A NURSING CORPORATION

NPI Number: 1154234342
Health Care Provider/Practitioner: EMPOWER WELLNESS CLINIC, A NURSING CORPORATION

Information about “1154234342” NPI (EMPOWER WELLNESS CLINIC, A NURSING CORPORATION) exists in 1154234342 in HTML format HTML  |  1154234342 in plain Text format TXT  |  1154234342 in PDF (Portable Document Format) PDF  |  1154234342 in an XML format XML  formats.

NPI Number : 1154234342 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154234342",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EMPOWER WELLNESS CLINIC, A NURSING CORPORATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4859 W SLAUSON AVE STE 168",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90056-1290",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-981-3161",
    "MailingAddressFaxNumber": "310-981-3165",
    "FirstLinePracticeLocationAddress": "275 W HOSPITALITY LN STE 307",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN BERNARDINO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92408-3265",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-981-3161",
    "PracticeLocationAddressFaxNumber": "310-981-3165",
    "EnumerationDate": "09/28/2026",
    "LastUpdateDate": "09/28/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FINLEY",
    "AuthorizedOfficialFirstName": "JACQUELINE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT/CEO",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "FNP-BC, PMHNP-BC",
    "AuthorizedOfficialTelephoneNumber": "310-981-3161",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LP2300X",
          "TaxonomyName": "Primary Care Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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