Provider Demographics
NPI:1346627171
Name:CORNERSTONE WELLNESS CENTER
Entity Type:Organization
Organization Name:CORNERSTONE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-373-6204
Mailing Address - Street 1:1088 CASS ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:831-373-6209
Practice Address - Street 1:1088 CASS ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4509
Practice Address - Country:US
Practice Address - Phone:831-373-6204
Practice Address - Fax:831-373-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty