Provider Demographics
NPI:1477110807
Name:ATHENA ACUPUNCTURE & WELLNESS CENTER
Entity Type:Organization
Organization Name:ATHENA ACUPUNCTURE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:626-221-9419
Mailing Address - Street 1:18354 LANACA ST
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-5923
Mailing Address - Country:US
Mailing Address - Phone:626-221-9419
Mailing Address - Fax:
Practice Address - Street 1:9209 COLIMA RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1800
Practice Address - Country:US
Practice Address - Phone:626-221-9419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty