Provider Demographics
NPI:1356640783
Name:WELLFIT, INCORPORATED
Entity Type:Organization
Organization Name:WELLFIT, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-492-2110
Mailing Address - Street 1:2825 J ST
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4300
Mailing Address - Country:US
Mailing Address - Phone:916-492-2110
Mailing Address - Fax:916-492-2111
Practice Address - Street 1:2825 J ST
Practice Address - Street 2:SUITE 440
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4300
Practice Address - Country:US
Practice Address - Phone:916-492-2110
Practice Address - Fax:916-492-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA792382081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty