Provider Demographics
NPI:1841557907
Name:THE WAY TO WELLNESS CENTER
Entity Type:Organization
Organization Name:THE WAY TO WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSERNIA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, PHD
Authorized Official - Phone:949-955-2655
Mailing Address - Street 1:23141 VERDUGO DRIVE
Mailing Address - Street 2:104
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1341
Mailing Address - Country:US
Mailing Address - Phone:949-305-9777
Mailing Address - Fax:949-955-2699
Practice Address - Street 1:23141 VERDUGO DRIVE
Practice Address - Street 2:104
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1341
Practice Address - Country:US
Practice Address - Phone:949-305-9777
Practice Address - Fax:949-955-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4591171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC4591OtherN/A