ANZA WELLNESS AND RECOVERY

Provider Demographics

• NPI: 1811605637
• Name: ANZA WELLNESS AND RECOVERY
• Entity type: Organization
• Organization Name: ANZA WELLNESS AND RECOVERY
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: CEO
• Authorized Official - Prefix: DR
• Authorized Official - First Name: CALEB
• Authorized Official - Middle Name: MAUTI
• Authorized Official - Last Name: REID
• Authorized Official - Credentials: DNP
• Authorized Official - Phone: 651-800-5900
• Mailing Address - Street 1: 350 E COMMERCIAL RD
• Mailing Address - Street 2: SUITE 112
• Mailing Address - City: SAN BERNARDINO
• Mailing Address - State: CA
• Mailing Address - Zip Code: 92408-3764
• Mailing Address - Country: US
• Mailing Address - Phone: 480-999-8200
• Mailing Address - Fax: 480-800-2212
• Practice Address - Street 1: 350 E. COMMERCIAL RD
• Practice Address - Street 2: SUITE 112
• Practice Address - City: SAN BERNARDINO
• Practice Address - State: CA
• Practice Address - Zip Code: 92408-3764
• Practice Address - Country: US
• Practice Address - Phone: 480-999-8200
• Practice Address - Fax: 480-800-2212
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2022-11-10
• Last Update Date: 2025-04-11

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2084A0401X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Addiction Medicine	Group - Multi-Specialty
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	2084P0802X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Addiction Psychiatry	Group - Multi-Specialty
No	2084P0804X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Child & Adolescent Psychiatry	Group - Multi-Specialty
No	2084P0805X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Geriatric Psychiatry	Group - Multi-Specialty
No	208600000X	Allopathic & Osteopathic Physicians	Surgery		Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)	Group - Multi-Specialty
No	261QM0855X	Ambulatory Health Care Facilities	Clinic/Center	Adolescent and Children Mental Health	Group - Multi-Specialty
No	261QP2300X	Ambulatory Health Care Facilities	Clinic/Center	Primary Care	Group - Multi-Specialty
No	363LP0808X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Psychiatric/Mental Health	Group - Multi-Specialty
No	101YM0800X	Behavioral Health & Social Service Providers	Counselor	Mental Health	Group - Multi-Specialty
No	103TA0400X	Behavioral Health & Social Service Providers	Psychologist	Addiction (Substance Use Disorder)	Group - Multi-Specialty
No	163WW0000X	Nursing Service Providers	Registered Nurse	Wound Care	Group - Multi-Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty