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General NPI Number Information
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NPI Number | 1942812250
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Entity Type | Organization
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Legal Business Name | OHANA HEALTH AND WELLNESS PLLC
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 10655 PARK RUN DR STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89144-4590
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Country | US
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Telephone | 702-659-6212
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Fax |
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Provider Business Mailing Address
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Address Line | 10655 PARK RUN DR STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89144-4590
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Country | US
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Telephone | 702-659-6212
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JAMIE FEJERAN
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Credential |
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Telephone | 858-353-3318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 106H00000X
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Taxonomy Name | Marriage & Family 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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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