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General NPI Number Information
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NPI Number | 1417535493
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Entity Type | Organization
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Legal Business Name | WELLSPOT HEALTHCARE
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 2595 E WASHINGTON BLVD STE 108
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City | PASADENA
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State | CA
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Zip | 91107-1409
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Country | US
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Telephone | 626-639-3887
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Fax | 626-228-2505
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Provider Business Mailing Address
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Address Line | 2595 E WASHINGTON BLVD STE 108
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City | PASADENA
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State | CA
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Zip | 91107-1409
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Country | US
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Telephone | 626-639-3887
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Fax | 626-228-2505
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Authorized Official
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Title or Position | CEO
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Name | JEANNIE WONG
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Credential | LAC
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Telephone | 323-639-3372
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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