ACTIVE WELLNESS LLC (NPI# 1114544970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114544970 |
| Entity Type | Organization |
| Organization Name | ACTIVE WELLNESS LLC |
| Practice Address |
600 California St Fl 11 San Francisco CA 94108-2727 |
| Mailing Address |
Po Box 2358 San Francisco CA 94126-2358 |
| Practice Telephone | 4153778595 |
| Mailing Telephone | 4153778595 |
| Enumeration Date | 2020-06-28 |
| Last Update Date | 2020-06-28 |
| Authorized Official Name | MR. THOMAS CAREY WHITE III (CFO) |
| Authorized Official Telephone | 4153778595 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1201X |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151595 | Active Wellness LLC | Occupational Therapist | 120 Sw 4th St Ste 170, Corvallis, OR 97333-4896 | 2019-08-27 |
| 1447685052 | Active Wellness LLC | Chiropractor | 338 E Ohio, Chicago, IL 60611 | 2013-09-13 |
| 1891120408 | Active Wellness LLC | Chiropractor | 560 W Diversey Pkwy, Chicago, IL 60614 | 2013-09-13 |
| 1427483791 | Active Wellness LLC | Chiropractor | 3514 N Southport Ave, Chicago, IL 60657-1436 | 2013-09-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ACTIVE WELLNESS LLC | 120 Sw 4th St Ste 170, Corvallis, OR 97333 |
| Colorado Business Entities | Active Wellness LLC | 7683 S Gartner Road, Evergreen, CO 80439 |
| Street Address |
600 CALIFORNIA ST FL 11 |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94108-2727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114189784 | Tiffany Rachel Lester | Clinic/Center | 600 California St Fl 11, San Francisco, CA 94108-2727 | 2008-06-25 |
| 1841807054 | Rose Tan | Dietitian, Registered | 600 California St Fl 11, San Francisco, CA 94108-2727 | 2020-09-30 |
| 1972146694 | Zipongo Health Provider Group P.a. | 600 California St Fl 11, San Francisco, CA 94108-2727 | 2019-10-25 | |
| 1306264643 | Dawn Marie Jacobson | Preventive Medicine | 600 California St Fl 11, San Francisco, CA 94108-2727 | 2014-04-03 |
| 1780913442 | Kerri Ann Masutto | Internal Medicine | 600 California St Fl 11, San Francisco, CA 94108 | 2009-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801431341 | Victoria Rae Storr | Psychologist | 447 Sutter St., Ste 429, San Francisco, CA 94108 | 2019-11-07 |
| 1104307792 | Kip Therapy Licensed Clinical Social Worker, P.C. | Psychologist | 600 California, San Francisco, CA 94108 | 2018-08-22 |
| 1245735752 | Adele Z Feng | Pharmacist | 251 Kearny St Fl 7, San Francisco, CA 94108 | 2018-03-27 |
| 1659818003 | Webster Surgery Center San Francisco, Lp | Clinic/Center | 450 Sutter St - Suite 400, San Francisco, CA 94108 | 2017-01-24 |
| 1114373370 | Daniel Peixoto Irby | Psychiatry & Neurology | 360 Post St Ste #500, San Francisco, CA 94108 | 2016-05-06 |
| 1902218837 | Deschamps-braly Foundation for Pediatric Craniofacial Maladies | Surgery | 450 Sutter St. #1520, San Francisco, CA 94108 | 2014-05-27 |
| 1356694202 | Chinese Hospital | Acupuncturist | 445 Grant Avenue, Ground Floor, San Francisco, CA 94108 | 2012-10-16 |
| 1831424464 | Kara Mosesso | Nurse Practitioner | 445 Bush St Ste 300, San Francisco, CA 94108 | 2009-10-15 |
| 1043451503 | Brandon Valor Brodt | Pharmacist | 450 Sutter St., Suite 713, San Francisco, CA 94108 | 2009-03-13 |
| 1194983312 | L Todd Iverson | Dentist | 450 Sutter St #2005, San Francisco, CA 94108 | 2008-05-23 |
| Find all providers in zip 94108 | ||||
| City | SAN FRANCISCO |
| Zip Code | 94108 |
Please comment or provide details below to improve the information on ACTIVE WELLNESS LLC.
| 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.