Provider Demographics
NPI:1437476660
Name:BE WELL NOW INSTITUTE
Entity Type:Organization
Organization Name:BE WELL NOW INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:M
Authorized Official - Last Name:VELASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-324-0447
Mailing Address - Street 1:20710 S. LEAPWOOD AVE. STE. C
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3642
Mailing Address - Country:US
Mailing Address - Phone:310-324-0447
Mailing Address - Fax:310-324-0147
Practice Address - Street 1:20710 LEAPWOOD AVE STE C
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3646
Practice Address - Country:US
Practice Address - Phone:310-324-0447
Practice Address - Fax:310-324-0147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53198A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health