Provider Demographics
NPI:1407585003
Name:WREN, HELEN M (FNTP)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:M
Last Name:WREN
Suffix:
Gender:F
Credentials:FNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35087 VIA SANTA CATALINA
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8586
Mailing Address - Country:US
Mailing Address - Phone:951-545-3791
Mailing Address - Fax:
Practice Address - Street 1:35087 VIA SANTA CATALINA
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8586
Practice Address - Country:US
Practice Address - Phone:951-545-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3856171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3856OtherTHE NUTRTIONAL THERAPY ASSOCIATION