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General NPI Number Information
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NPI Number | 1346748480
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Entity Type | Organization
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Legal Business Name | VITALITY WELLNESS CENTER, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1011 CENTER ST
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3703
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Country | US
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Telephone | 831-325-9691
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Fax | 831-295-6206
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Provider Business Mailing Address
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Address Line | 413 OXFORD WAY
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City | SANTA CRUZ
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State | CA
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Zip | 95060-6350
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Country | US
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Telephone | 408-402-1849
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Fax |
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Authorized Official
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Title or Position | SECREATRY
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Name | MR. NEIL BERNARDI-WRIGHT
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Credential | L.AC.
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Telephone | 408-402-1849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC4876
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC4888
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License Number State | CA
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