PEDIATRIC HEALTH AND WELLNESS NPI 1124426580

NPI Information

NPI: 1124426580
Provider Name: PEDIATRIC HEALTH AND WELLNESS

Doing Business As: PROYOUTH

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 05D2057507

Address:
6815 FIVE STAR BLVD STE 100
ROCKLIN, CA
ZIP 95677
Phone: (916) 626-3060
Get Directions

PEDIATRIC HEALTH AND WELLNESS is a primary care clinic center in Rocklin, CA. PEDIATRIC HEALTH AND WELLNESS NPI is 1124426580. The provider is registered as an organization entity type.
The provider Is Doing Business As Proyouth.

The provider's business location address is:

6815 FIVE STAR BLVD STE 100
ROCKLIN, CA
ZIP 95677
Phone: (916) 626-3060
Fax: (916) 626-3063

The provider's authorized official is Sunnie L Skiles .
The authorized official title is Md and has the following contact phone number (916) 626-3060.

The CLIA number assigned to this NPI record is 05D2057507 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2014 and was last updated on 8/29/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	G66133	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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