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General NPI Number Information
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NPI Number | 1952770448
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Entity Type | Individual
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Provider Name | WANDA WEST
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Gender | Female
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 5220 CLARK AVE STE 445
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City | LAKEWOOD
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State | CA
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Zip | 90712-2630
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Country | US
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Telephone | 310-936-4621
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Fax | 310-568-9583
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Provider Business Mailing Address
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Address Line | PO BOX 452103
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City | WESTCHESTER
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State | CA
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Zip | 90045-8527
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Country | US
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Telephone | 310-936-4621
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Fax | 310-568-9583
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 11797
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License Number State | CA
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