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General NPI Number Information
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NPI Number | 1447871272
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Entity Type | Organization
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Legal Business Name | WELLMIND.ONLINE CA LICENSED CLINICAL SOCIAL WORKER PROF. CORP.
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2100 GENG RD STE 210
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City | PALO ALTO
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State | CA
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Zip | 94303-3307
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Country | US
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Telephone | 833-646-3243
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Fax | 650-414-0378
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Provider Business Mailing Address
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Address Line | 2100 GENG RD STE 210
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City | PALO ALTO
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State | CA
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Zip | 94303-3307
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Country | US
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Telephone | 707-888-6813
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Fax | 650-414-0378
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Authorized Official
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Title or Position | CEO
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Name | LAURA BEANN
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Credential | LCSW
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Telephone | 833-646-3243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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