Provider Demographics
NPI:1003454257
Name:ADVANCED HEALTH PREFERENCE GROUP INC A PROFESSIONAL NURSING CORP
Entity Type:Organization
Organization Name:ADVANCED HEALTH PREFERENCE GROUP INC A PROFESSIONAL NURSING CORP
Other - Org Name:AHPG WELLNESS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUCIER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:310-864-8885
Mailing Address - Street 1:12340 SEAL BEACH BLVD # B187
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2792
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12340 SEAL BEACH BLVD # B187
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2792
Practice Address - Country:US
Practice Address - Phone:310-503-5813
Practice Address - Fax:310-300-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty