Provider Demographics
NPI:1275937682
Name:EMMONS STUDENT WELLNESS CENTER
Entity Type:Organization
Organization Name:EMMONS STUDENT WELLNESS CENTER
Other - Org Name:EMMONS HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-259-2657
Mailing Address - Street 1:1600 CAMPUS RD # F-57
Mailing Address - Street 2:EMMONS WELLNESS CENTER
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-3314
Mailing Address - Country:US
Mailing Address - Phone:323-259-2657
Mailing Address - Fax:
Practice Address - Street 1:1600 CAMPUS RD # F-57
Practice Address - Street 2:EMMONS WELLNESS CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-3314
Practice Address - Country:US
Practice Address - Phone:323-259-2657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCCIDENTAL COLLEGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health