WAVELENGTHS RECOVERY NPI 1174146658

NPI Information

  • NPI: 1174146658
  • Provider Name: WAVELENGTHS RECOVERY
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Address: 6 PETALUMA BLVD N STE A7
    PETALUMA, CA
    ZIP 94952
  • Phone: (714) 312-1011

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NPI Details

WAVELENGTHS RECOVERY is a rehabilitation and substance use disorder clinic center in Petaluma, CA. WAVELENGTHS RECOVERY NPI is 1174146658. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6 PETALUMA BLVD N STE A7
PETALUMA, CA
ZIP 94952-027
Phone: (714) 312-1011

The provider's authorized official is Warren Boyd .
The authorized official title is Ceo and has the following contact phone number (714) 642-2404.

The enumeration date for this NPI number is 5/19/2020 and was last updated on 5/19/2020.

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
1101Y00000XCounselorNo
2101YA0400XCounselorAddiction (Substance Use Disorder)No
3101YM0800XCounselorMental HealthNo
4103TA0400XPsychologistAddiction (Substance Use Disorder)No
5103TP2701XPsychologistGroup PsychotherapyNo
6225C00000XRehabilitation CounselorNo
7261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)No
8261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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: 11/21/2025

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