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General NPI Number Information
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NPI Number | 1528657160
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Entity Type | Organization
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Legal Business Name | MIND WELLNESS CENTER INC.
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Dates
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Enumeration Date | 01/17/2021
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Last Update Date | 01/17/2021
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Provider Practice Location Address
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Address Line | 1701 WESTWIND DR STE 215
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City | BAKERSFIELD
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State | CA
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Zip | 93301-3047
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Country | US
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Telephone | 951-334-7172
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Fax | 909-755-5188
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Provider Business Mailing Address
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Address Line | 5050 JUNEAU CT
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2653
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Country | US
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Telephone | 951-334-7172
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Fax | 909-755-5188
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Authorized Official
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Title or Position | CEO
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Name | DR. CALLISTUS EMEKA AMAJOYI
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Credential | PHD
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Telephone | 951-334-7172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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