Pediatric Health And Wellness
Clinic/Center, Primary Care in Rocklin, CA. Organization (NPI-2).
NPI number1124426580
StatusActive
Last updated in NPPESAug 29, 2018
Details
- NPI
- 1124426580
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Health And Wellness
- Organization subpart
- No
- Enumeration date
- Dec 16, 2014
- Last updated
- Aug 29, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | g66133 | CA | Yes |
Other names
- Proyouth (Doing Business As)
Practice location
6815 Five Star Blvd Ste 100Rocklin, CA 95677
Phone 916-626-3060 · Fax 916-626-3063
Mailing address
6815 Five Star Blvd Ste 100Rocklin, CA 95677-2691
Phone 916-626-3060 · Fax 916-626-3063
Authorized official
Sunnie L Skiles
MD
9166263060
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