Provider Demographics
NPI:1619481454
Name:HEALING COMPASS NATURAL HEALTH CENTER
Entity Type:Organization
Organization Name:HEALING COMPASS NATURAL HEALTH CENTER
Other - Org Name:HEALING COMPASS NATURAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVEKA
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPL OM
Authorized Official - Phone:818-591-8600
Mailing Address - Street 1:24007 VENTURA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2549
Mailing Address - Country:US
Mailing Address - Phone:818-591-8600
Mailing Address - Fax:818-225-8597
Practice Address - Street 1:24007 VENTURA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2549
Practice Address - Country:US
Practice Address - Phone:818-591-8600
Practice Address - Fax:818-225-8597
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING COMPASS & QI CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9004133NN1002X, 171100000X
CA8942133NN1002X, 171100000X
CA6386133NN1002X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty