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General NPI Number Information
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NPI Number | 1235674433
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Entity Type | Organization
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Legal Business Name | RESILIENCE NATUROPATHIC INC.
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Dates
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Enumeration Date | 12/23/2016
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Last Update Date | 12/23/2016
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Provider Practice Location Address
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Address Line | 3633 CAMINO DEL RIO S SUITE 103
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City | SAN DIEGO
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State | CA
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Zip | 92108-4011
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Country | US
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Telephone | 858-461-8121
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Fax | 818-659-3175
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Provider Business Mailing Address
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Address Line | 3633 CAMINO DEL RIO S SUITE 103
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City | SAN DIEGO
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State | CA
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Zip | 92108-4011
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Country | US
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Telephone | 858-461-8121
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Fax | 818-659-3175
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | JENNIFER KAY BAHR
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Credential | ND
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Telephone | 858-461-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND-548
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License Number State | CA
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