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General NPI Number Information
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NPI Number | 1184594343
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Entity Type | Organization
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Legal Business Name | TELEWEIGHT AND WELLNESS CLINIC INC
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 626-654-4820
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Fax | 949-864-3876
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Provider Business Mailing Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 626-654-4820
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Fax | 949-864-3876
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Authorized Official
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Title or Position | OWNER
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Name | NANCY CALLAHAM
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Credential | PA-C
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Telephone | 626-654-4820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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