Provider Demographics
NPI:1205811122
Name:THE WHOLE WOMAN, INCORPORATED
Entity type:Organization
Organization Name:THE WHOLE WOMAN, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MCCULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP, LM
Authorized Official - Phone:805-584-7092
Mailing Address - Street 1:2950 SYCAMORE DR
Mailing Address - Street 2:SUITE #201
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1210
Mailing Address - Country:US
Mailing Address - Phone:805-584-7092
Mailing Address - Fax:805-584-7096
Practice Address - Street 1:2950 SYCAMORE DR
Practice Address - Street 2:SUITE #201
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1210
Practice Address - Country:US
Practice Address - Phone:805-584-7092
Practice Address - Fax:805-584-7096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 429440251J00000X, 261QB0400X, 363LW0102X
CAMIDWIFE #134261QB0400X
CAFURNISHING 9578332BN1400X, 332BP3500X, 332BX2000X
CADEA# MM0542476333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251J00000XAgenciesNursing Care
Not Answered261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered333600000XSuppliersPharmacy
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA429440OtherNURSE PRACTITIONER
CALM 134OtherLICENSED MIDWIFE
CA9578OtherNP FURNISHING LICENSE
CALM 134OtherLICENSED MIDWIFE