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General NPI Number Information
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NPI Number | 1962317677
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Entity Type | Organization
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Legal Business Name | 2ND WAVE INDUSTRIES
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 190 SIERRA CT STE 204
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City | PALMDALE
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State | CA
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Zip | 93550-7615
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Country | US
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Telephone | 661-916-7356
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Fax |
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Provider Business Mailing Address
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Address Line | 1217 E PONDERA ST
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City | LANCASTER
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State | CA
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Zip | 93535-3302
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Country | US
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Telephone | 661-916-7356
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA KESTNER
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Credential |
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Telephone | 661-916-7356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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