WISE &HEALTHY AGING (NPI# 1134399165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134399165 |
| Entity Type | Organization |
| Organization Name | WISE &HEALTHY AGING |
| Practice Address |
1527 4th St 3rd Floor Santa Monica CA 90401-2358 |
| Mailing Address |
1527 4th St 2nd Floor Santa Monica CA 90401-2358 |
| Practice Telephone | 3103949871 |
| Practice Fax Number | 3105762499 |
| Mailing Telephone | 3103949871 |
| Mailing Fax Number | 3105762499 |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2013-09-17 |
| Authorized Official Name | MS. GRACE CHENG BRAUN (PRESIDENT & CEO) |
| Authorized Official Telephone | 3103949871 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PROVIDER NUMBER | W13662 | 01 |
| Street Address |
1527 4TH ST 3RD FLOOR |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90401-2358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538106455 | Center for Healthy Aging | Clinic/Center | 1527 4th St, Santa Monica, CA 90401-2354 | 2006-05-31 |
| 1790264083 | Wendy Nishikawa Jaffa | Social Worker | 1527 4th St, Santa Monica, CA 90401-2358 | 2018-08-08 |
| 1760976070 | Michael Lopez | Rehabilitation Practitioner | 1527 4th St, Santa Monica, CA 90401-2358 | 2018-06-20 |
| 1699205641 | Kyle Justin Difulvio | Student in an Organized Health Care Education/Training Program | 1527 4th St, Santa Monica, CA 90401-2358 | 2017-06-13 |
| 1851743850 | Ryan Witherspoon | Student in an Organized Health Care Education/Training Program | 1527 4th St, 2nd Floor, Santa Monica, CA 90401-2358 | 2016-07-01 |
| 1437500857 | Dawn Glover | Student in an Organized Health Care Education/Training Program | 1527 4th St, 2nd Floor, Santa Monica, CA 90401-2358 | 2016-06-27 |
| 1235514613 | Hannah Salanoa-ogbechie | Rehabilitation Practitioner | 1527 4th St, Santa Monica, CA 90401 | 2015-07-27 |
| 1538568118 | Laurel Cleary | Student in an Organized Health Care Education/Training Program | 1527 4th St, Santa Monica, CA 90401-2358 | 2014-08-19 |
| 1215343595 | Peter Gleiberman Jr. | Student in an Organized Health Care Education/Training Program | 1527 4th St, Santa Monica, CA 90401-2358 | 2014-07-07 |
| 1396163366 | Blaine Mcfadden | Social Worker | 1527 4th St, Santa Monica, CA 90401-2358 | 2014-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013499458 | Franchesca Johnson Gordon | Marriage & Family Therapist | 900 Wilshire Blvd., Ste. 450, Santa Monica, CA 90401 | 2018-09-01 |
| 1629564083 | Michelle Jillian Dolinsky | Social Worker | 1243 7th St Ste C, Santa Monica, CA 90401 | 2018-07-09 |
| 1528507084 | Doctor Tlc, License Clinical Psychologist, Inc. | Community/Behavioral Health | 1242 Third St Promenade, Suite 208, Santa Monica, CA 90401 | 2017-02-16 |
| 1285006023 | Venessa Leeann Roca | Speech-Language Pathologist | 1218 6th Street, Santa Monica, CA 90401 | 2015-10-20 |
| 1720468036 | Stephen J. Kenneally | Marriage & Family Therapist | 610 Santa Monica Bvd, Ste. 201, Santa Monica, CA 90401 | 2015-06-02 |
| 1629458070 | Dominique L Robertson | Marriage & Family Therapist | 530 Wilshire, #310, Santa Monica, CA 90401 | 2015-06-01 |
| 1205252673 | Santa Monica Sports Medicine Inc. | Physical Medicine & Rehabilitation | 900 Wilshire Blvd. #410, Santa Monica, CA 90401 | 2014-03-10 |
| 1154675023 | Sherry Marie Martyn | Psychologist | 1242 3rd Street Promenade Ste 208, Santa Monica, CA 90401 | 2012-10-31 |
| 1700159829 | Gary Warburton | Dentist | 519 Arizona Ave., Santa Monica, CA 90401 | 2012-02-21 |
| 1265713036 | Aleksandr Mailyan | Reflexologist | 201 Wilshire Blvd #101, Santa Monica, CA 90401 | 2011-09-07 |
| Find all providers in zip 90401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801407945 | Behavioral Health Services, Inc. | Community/Behavioral Health | 1424 4th St Ste 205, Santa Monica, CA 90401-2352 | 2020-08-12 |
| 1144797697 | Vista Del Mar Child and Family Services | Community/Behavioral Health | 601 Pico Blvd. Ad 508-513, Santa Monica, CA 90405-1224 | 2018-11-01 |
| 1528507084 | Doctor Tlc, License Clinical Psychologist, Inc. | Community/Behavioral Health | 1242 Third St Promenade, Suite 208, Santa Monica, CA 90401 | 2017-02-16 |
| 1063878510 | Clare Matrix | Community/Behavioral Health | 1002 Pico Blvd, Santa Monica, CA 90405-1416 | 2016-01-13 |
| 1003159203 | Step By Step Edu-play | Community/Behavioral Health | 1412 14th St, Santa Monica, CA 90404-2704 | 2013-04-05 |
| 1912242413 | Early Start Preschools | Community/Behavioral Health | 2505 Lincoln Blvd, Santa Monica, CA 90405-3817 | 2012-12-10 |
| 1376800722 | The People Concern | Community/Behavioral Health | 1749 14th St, Santa Monica, CA 90404-4342 | 2012-04-23 |
| 1477829786 | Step-by-step Edu Play Programs | Community/Behavioral Health | 1814 14th St, 203, Santa Monica, CA 90404-7028 | 2012-03-30 |
| 1376811992 | The People Concern | Community/Behavioral Health | 503 Olympic Blvd, Santa Monica, CA 90401-3311 | 2011-12-09 |
| 1073804738 | Clare Matrix | Community/Behavioral Health | 1020 Pico Blvd, Santa Monica, CA 90405-1416 | 2011-04-28 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90401 |
Please comment or provide details below to improve the information on WISE &HEALTHY AGING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.