Provider Demographics
NPI:1871984633
Name:VALLEY WHOLISTIC HEALTH CENTER
Entity type:Organization
Organization Name:VALLEY WHOLISTIC HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-887-4000
Mailing Address - Street 1:22030 CLARENDON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6316
Mailing Address - Country:US
Mailing Address - Phone:818-887-4000
Mailing Address - Fax:818-332-4133
Practice Address - Street 1:22030 CLARENDON ST
Practice Address - Street 2:101
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6316
Practice Address - Country:US
Practice Address - Phone:818-887-4000
Practice Address - Fax:818-332-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty