Provider Demographics
NPI:1780320457
Name:PERSONAL HEALTH DESIGN HEALTH COACHING
Entity type:Organization
Organization Name:PERSONAL HEALTH DESIGN HEALTH COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. HEALTH COACH
Authorized Official - Prefix:
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-223-0744
Mailing Address - Street 1:2300 STANWELL DR STE A
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4841
Mailing Address - Country:US
Mailing Address - Phone:510-224-0744
Mailing Address - Fax:
Practice Address - Street 1:2300 STANWELL DR STE A
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4841
Practice Address - Country:US
Practice Address - Phone:510-224-0744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty