Provider Demographics
NPI:1235674433
Name:RESILIENCE NATUROPATHIC INC.
Entity Type:Organization
Organization Name:RESILIENCE NATUROPATHIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BAHR
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:858-461-8121
Mailing Address - Street 1:3633 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4011
Mailing Address - Country:US
Mailing Address - Phone:858-461-8121
Mailing Address - Fax:818-659-3175
Practice Address - Street 1:3633 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4011
Practice Address - Country:US
Practice Address - Phone:858-461-8121
Practice Address - Fax:818-659-3175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-548175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty