Provider Demographics
NPI:1871949594
Name:ANXIETY TO WELLNESS
Entity type:Organization
Organization Name:ANXIETY TO WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RIDDLE-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:760-715-7273
Mailing Address - Street 1:PO BOX 2907
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92033-2907
Mailing Address - Country:US
Mailing Address - Phone:760-715-7273
Mailing Address - Fax:760-743-6711
Practice Address - Street 1:502 W EL NORTE PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-3983
Practice Address - Country:US
Practice Address - Phone:760-715-7273
Practice Address - Fax:760-743-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty