MEDICARE: WELLNESS AND EDUCATION GROUP, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	28730	CA

General Provider Information

NPI Number	:	1497231658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS AND EDUCATION GROUP, INC

Provider Business Mailing Address
First Line	:	4605 LANKERSHIM BLVD STE 720
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-1878
Country	:	US
Telephone Number	:	310-270-5523
Fax Number	:

Provider Business Practice Location Address
First Line	:	4605 LANKERSHIM BLVD STE 720
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-1878
Country	:	US
Telephone Number	:	310-270-5523
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	MS. AFSANEH YOCHEVED BALAKHANEH
Credential	:	LCSW
Telephone Number	:	310-270-5523

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	07/23/2024

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