Provider Demographics
NPI:1912660796
Name:MEDITATIVE MINDS COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:MEDITATIVE MINDS COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-285-8466
Mailing Address - Street 1:11446 AARON AVE
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-6264
Mailing Address - Country:US
Mailing Address - Phone:805-285-8466
Mailing Address - Fax:
Practice Address - Street 1:2806 COCHRAN ST STE A
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2780
Practice Address - Country:US
Practice Address - Phone:805-285-8466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty