Provider Demographics
NPI:1922790906
Name:WHOLE PERSON CARE CLINIC
Entity Type:Organization
Organization Name:WHOLE PERSON CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LELIA
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:760-385-3739
Mailing Address - Street 1:120 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-3058
Mailing Address - Country:US
Mailing Address - Phone:760-385-3739
Mailing Address - Fax:888-800-8226
Practice Address - Street 1:120 N ASH ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3058
Practice Address - Country:US
Practice Address - Phone:760-385-3739
Practice Address - Fax:888-800-8226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251B00000XAgenciesCase Management
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care