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General NPI Number Information
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NPI Number | 1326677113
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Entity Type | Organization
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Legal Business Name | WOMEN RISE PSYCHOLOGICAL AND WELLNESS CENTER, P.C.
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 250 W 1ST ST STE 314
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City | CLAREMONT
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State | CA
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Zip | 91711-4741
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Country | US
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Telephone | 909-294-7012
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Fax |
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Provider Business Mailing Address
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Address Line | 250 W 1ST ST STE 314
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City | CLAREMONT
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State | CA
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Zip | 91711-4741
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Country | US
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Telephone | 909-294-7012
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JANIEL LASHA HENRY
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Credential | PSY.D.
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Telephone | 909-294-7012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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