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General NPI Number Information
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NPI Number | 1306713227
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Entity Type | Organization
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Legal Business Name | HEALTH EMPOWERMENT THROUGH ACTIVE LEADERSHIP
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 5250 UNIVERSITY PKWY
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-7051
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Country | US
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Telephone | 909-310-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 1013 SUNBROOK DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-5357
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARIAH Y GRAJEDA
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Credential |
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Telephone | 951-805-9856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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