Provider Demographics
NPI:1568197564
Name:READY FOR WELLNESS
Entity Type:Organization
Organization Name:READY FOR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUICHI
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:409-296-9009
Mailing Address - Street 1:2211 MOORPARK AVE STE 250B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2656
Mailing Address - Country:US
Mailing Address - Phone:408-296-9009
Mailing Address - Fax:
Practice Address - Street 1:2211 MOORPARK AVE STE 250B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2656
Practice Address - Country:US
Practice Address - Phone:408-296-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14344642OtherCAQH