Provider Demographics
NPI:1497480594
Name:WELLNESS WITH ANDREA JAKUCS & ASSOCIATES
Entity Type:Organization
Organization Name:WELLNESS WITH ANDREA JAKUCS & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKUCS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-714-8258
Mailing Address - Street 1:2591 FAIR OAKS AVE # 226
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2591 FAIR OAKS AVE # 226
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-5074
Practice Address - Country:US
Practice Address - Phone:626-714-8258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty