WHOLESOME COMMUNITY MEMBERS CLUB INC


Address: 6309 Van Nuys Blvd Ste 102, Van Nuys, CA 91401-6629
Phone: 8182399586

WHOLESOME COMMUNITY MEMBERS CLUB INC (NPI# 1396210373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396210373
Entity Type Organization
Organization Name WHOLESOME COMMUNITY MEMBERS CLUB INC
Practice Address 6309 Van Nuys Blvd Ste 102
Van Nuys
CA 91401-6629
Mailing Address Po Box 1763
Sun Valley
CA 91353-1763
Practice Telephone 8182399586
Mailing Telephone 8182399586
Enumeration Date 2018-10-05
Last Update Date 2019-04-10
Authorized Official Name MELVIN DOUGLAS MITCHELL (NURSE PRACTITIONER)
Authorized Official Telephone 8182399586
Authorized Official Credential PMHNP-BC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 251S00000X Community/Behavioral Health Agencies
N 251V00000X Voluntary or Charitable Agencies
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 6309 VAN NUYS BLVD STE 102
City VAN NUYS
State CA
Zip Code 91401-6629

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437453297 Stephanie Ann Westerfield Nurse Practitioner 16360 Roscoe Blvd, 2nd Floor, Van Nuys, CA 91406-1219 2011-01-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1477154573 Marcus Jang Nurse Practitioner 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 2020-11-04
1033718580 John Sylvanus Allieu Sr. Nurse Practitioner 2672 Merganser Ct, Los Banos, CA 93635-9473 2020-10-25
1316546930 Chika U Oguagha Nurse Practitioner 16240 Carmine St, Fontana, CA 92336-1481 2020-10-23
1215534888 Rosa Maria Aguero Nurse Practitioner 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 2020-10-06
1134726995 Margarita Maghtesyan Nurse Practitioner 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 2020-10-05
1043827140 April Lopez Ortiz Nurse Practitioner 500 W Ashland Ct, Visalia, CA 93277-6609 2020-09-23
1477167666 David Joseph Russell Nurse Practitioner 17846 Glenwood Rd, Manteca, CA 95336-9521 2020-09-03
1194339382 Albert Liu Nurse Practitioner 43559 Southerland Way, Fremont, CA 94539-5931 2020-09-03
1407469554 Andre Alexandrian Nurse Practitioner 1606 Winona Ave, Burbank, CA 91504-2823 2020-08-28
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Competitor

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City VAN NUYS
Zip Code 91401

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Dataset Information

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.

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