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General NPI Number Information
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NPI Number | 1801092895
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Entity Type | Organization
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Legal Business Name | BODYSCOPE INSTITUTE LLC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 500 OLD NEWPORT BLVD SUITE 200A
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4234
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Country | US
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Telephone | 949-515-8004
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Fax | 949-515-8014
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Provider Business Mailing Address
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Address Line | 500 OLD NEWPORT BLVD SUITE 200A
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4234
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Country | US
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Telephone | 949-515-8004
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Fax | 949-515-8014
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Authorized Official
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Title or Position | OWNER OPERATOR LICENSED PRACTITIONE
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Name | MS. JANICE L SIMMONS
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Credential | MS HHP
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Telephone | 949-515-8004
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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 | HHP040902
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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 | LAC AC3606
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License Number State | CA
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