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General NPI Number Information
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NPI Number | 1164129292
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL MINDS WELLNESS
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 13300 NEW AIRPORT RD STE 102
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City | AUBURN
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State | CA
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Zip | 95602-7407
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Country | US
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Telephone | 530-217-3870
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Fax |
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Provider Business Mailing Address
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Address Line | 13300 NEW AIRPORT RD STE 102
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City | AUBURN
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State | CA
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Zip | 95602-7407
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Country | US
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Telephone | 530-217-3870
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JASON BROWN
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Credential |
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Telephone | 530-217-3870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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