WELLNESS INTERPROFESSIONAL PHYSICAL THERAPY CORPORATION, PC (NPI# 1134535750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134535750 |
| Entity Type | Organization |
| Organization Name | WELLNESS INTERPROFESSIONAL PHYSICAL THERAPY CORPORATION, PC |
| Other Organization Name | METROHEALTH STATION, PC |
| Practice Address |
3501 W Jefferson Blvd Los Angeles CA 90018-3237 |
| Practice Telephone | 3237301205 |
| Practice Fax Number | 2132214778 |
| Mailing Telephone | 3237301205 |
| Mailing Fax Number | 2132214778 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2016-05-18 |
| Authorized Official Name | DR. KATHERINE JOSEPHINE SULLIVAN (CEO/PRESIDENT) |
| Authorized Official Telephone | 3237301205 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | 53973 | CA | Behavioral Health & Social Service Providers |
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
87429 | CA | Allopathic & Osteopathic Physicians |
| N | 1223G0001X |
Dentist Specialization: General Practice |
63162 | CA | Dental Providers |
| N | 106H00000X | Marriage & Family Therapist | 80856 | CA | Behavioral Health & Social Service Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
22533 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
44450 | CA | Dental Providers |
| N | 2251N0400X |
Physical Therapist Specialization: Neurology |
14280 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
40379 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
15587 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
14280 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MetroHealth Station, PC | Doing Business As Name - Organization |
| Street Address |
3501 W JEFFERSON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90018-3237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922194174 | Brian Duane Prestwich | Family Medicine | 3501 W Jefferson Blvd, Los Angeles, CA 90018-3237 | 2006-10-05 |
| 1821498890 | Anita Christine Correa | Physical Therapist | 3501 W Jefferson Blvd, Los Angeles, CA 90018-3237 | 2014-08-27 |
| 1740689751 | Michelle Elizabeth Farmer | Occupational Therapist | 3501 W Jefferson Blvd, Los Angeles, CA 90018-3237 | 2014-08-14 |
| 1962741132 | William Mark Korn | Social Worker | 3501 W Jefferson Blvd, Los Angeles, CA 90018-3237 | 2013-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753429 | Gilda Panales | Behavioral Analyst | 2919 1/2 South Bronson Ave, Los Angeles, CA 90018 | 2018-06-14 |
| 1083125603 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3601 2nd Ave, Los Angeles, CA 90018 | 2017-10-23 |
| 1598292351 | Brittney Shanice Hinton | Counselor | 3125 W Adams Blvd, #9, Los Angeles, CA 90018 | 2017-05-11 |
| 1639556632 | Erica Gladden | Radiologic Technologist | 2923 South Dalton Ave, Los Angeles, CA 90018 | 2015-04-29 |
| 1881085942 | Tanisha Merriweather | Counselor | 3521 11th Ave, Los Angeles, CA 90018 | 2015-02-11 |
| 1790088763 | Richard Windom | Counselor | 1361 Exposition Blvd., Los Angeles, CA 90018 | 2010-12-14 |
| 1790095214 | Donielle Spencer | Rehabilitation Practitioner | 1968 W Adams Blvd., Ste 101, Los Angeles, CA 90018 | 2010-10-18 |
| 1780906404 | Earl Cooper | Internal Medicine | 2424 8th Ave., Los Angeles, CA 90018 | 2010-02-22 |
| 1295066207 | Gilda Beatriz Gomez | Rehabilitation Practitioner | 2116 Arlington Ave. Suite 200, Los Angeles, CA 90018 | 2010-01-15 |
| 1922332899 | Roberto Carlos Cisnerso | Counselor | 2357 W. 30th St., Los Angeles, CA 90018 | 2009-09-25 |
| Find all providers in zip 90018 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1194297895 | Benevolence Industries Inc. | Clinic/Center | 2065 W 6th St Ste 110, Los Angeles, CA 90057-3180 | 2018-12-19 |
| 1699245654 | Evolved, Inc. | Clinic/Center | 10573 W Pico Blvd Unit 414, Los Angeles, CA 90064-2333 | 2018-12-03 |
| 1164999215 | Bobby Pezeshki Md Inc | Clinic/Center | 2011 Wilshire Blvd Ste 300, Los Angeles, CA 90057-3503 | 2018-10-26 |
| 1629567060 | Dtla Med | Clinic/Center | 431 S Hewitt St Ste B, Los Angeles, CA 90013 | 2018-05-01 |
| 1275030009 | M Pakour Md Inc | Clinic/Center | 3671 W 6th St Ste B, Los Angeles, CA 90020-3026 | 2018-04-09 |
| 1083142376 | Advanced Hematology Oncology Medical Group Inc | Clinic/Center | 6221 Wilshire Blvd Ste 504, Los Angeles, CA 90048-5223 | 2017-05-31 |
| 1033516943 | Uc Regents | Clinic/Center | 10833 Le Conte, Los Angeles, CA 90095-1752 | 2014-11-21 |
| 1962811265 | County of Los Angeles - Auditor Controller | Clinic/Center | 1670 East 120 Th Street, Martin Luther King Jr. Pharmacy, Los Angeles, CA 90059-3019 | 2014-08-12 |
| 1952526915 | Silka Enterprises Inc | Clinic/Center | 5230 W Sunset Blvd Ste B, Los Angeles, CA 90027-5736 | 2007-04-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90018 |
Please comment or provide details below to improve the information on WELLNESS INTERPROFESSIONAL PHYSICAL THERAPY CORPORATION, PC.
| 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.