Provider Demographics
NPI:1609929058
Name:INBALANCE, A WOMEN'S HEALTH & WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:INBALANCE, A WOMEN'S HEALTH & WELLNESS CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SEDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:949-218-4141
Mailing Address - Street 1:31105 RANCHO VIEJO RD
Mailing Address - Street 2:SUITE C5
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1717
Mailing Address - Country:US
Mailing Address - Phone:949-218-4141
Mailing Address - Fax:949-218-4242
Practice Address - Street 1:31105 RANCHO VIEJO RD
Practice Address - Street 2:SUITE C5
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1717
Practice Address - Country:US
Practice Address - Phone:949-218-4141
Practice Address - Fax:949-218-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21120261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy