Provider Demographics
NPI:1194464230
Name:DOWNLOAD WELLNESS
Entity Type:Organization
Organization Name:DOWNLOAD WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMT
Authorized Official - Prefix:MS
Authorized Official - First Name:SURMICHE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-688-2919
Mailing Address - Street 1:1211 EMBARCADERO STE D
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5117
Mailing Address - Country:US
Mailing Address - Phone:510-328-4098
Mailing Address - Fax:
Practice Address - Street 1:1211 EMBARCADERO STE D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5117
Practice Address - Country:US
Practice Address - Phone:510-328-4098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty