Provider Demographics
NPI:1699383661
Name:TRANSGENDER HEALTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:TRANSGENDER HEALTH AND WELLNESS CENTER
Other - Org Name:TRANSGENDER HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-202-4308
Mailing Address - Street 1:35325 DATE PALM DR STE 143
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7031
Mailing Address - Country:US
Mailing Address - Phone:760-202-4308
Mailing Address - Fax:760-818-8025
Practice Address - Street 1:6700 INDIANA AVE STE 252
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4264
Practice Address - Country:US
Practice Address - Phone:760-202-4308
Practice Address - Fax:760-818-8025
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSGENDER HEALTH AND WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-16
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty