Provider Demographics
NPI:1659179752
Name:PACIFIC WELLNESS & INTEGRATIVE FAMILY PSYCHIATRY
Entity type:Organization
Organization Name:PACIFIC WELLNESS & INTEGRATIVE FAMILY PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH NP
Authorized Official - Prefix:
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANSON
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:619-518-0755
Mailing Address - Street 1:2120 LOWER KULA RD
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-8713
Mailing Address - Country:US
Mailing Address - Phone:619-518-0755
Mailing Address - Fax:
Practice Address - Street 1:2120 LOWER KULA RD
Practice Address - Street 2:
Practice Address - City:KULA
Practice Address - State:HI
Practice Address - Zip Code:96790-8713
Practice Address - Country:US
Practice Address - Phone:619-518-0755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty