Provider Demographics
NPI:1598013179
Name:WORKPLACE WELLNESS
Entity Type:Organization
Organization Name:WORKPLACE WELLNESS
Other - Org Name:BCIP
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCWS
Authorized Official - Phone:209-525-4974
Mailing Address - Street 1:2101 GEER ROAD STE 120
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380
Mailing Address - Country:US
Mailing Address - Phone:209-525-4974
Mailing Address - Fax:209-664-8523
Practice Address - Street 1:2101 GEER ROAD STE 120
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380
Practice Address - Country:US
Practice Address - Phone:209-525-4974
Practice Address - Fax:209-664-8523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health