Organization · NPI-2

Preventive Health Essentials INC

Nurse Practitioner, Gerontology · Palm Desert, CA

NPI number1235294893

StatusActive

Last updated in NPPESDec 19, 2016

Details

NPI: 1235294893
Entity type: Organization (NPI-2)
Legal business name: Preventive Health Essentials INC
Organization subpart: Yes
Enumeration date: Dec 26, 2006
Last updated: Dec 19, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LG0600X	Nurse Practitioner, Gerontology	G1112004	CA	Yes
163WG0600X	Registered Nurse, Gerontology	514131	CA
163WR0006X	Registered Nurse, Registered Nurse First Assistant	514131	CA
163WP0808X	Registered Nurse, Psych/Mental Health	514131	CA
171M00000X	Case Manager/Care Coordinator	95090658	CA
163WG0000X	Registered Nurse, General Practice	11282	CA
364SC2300X	Clinical Nurse Specialist, Chronic Care	11282	CA
101YM0800X	Counselor, Mental Health	514131	CA
363LP0808X	Nurse Practitioner, Psych/Mental Health	11282	CA
163WC0400X	Registered Nurse, Case Management	514131	CA

Other names

Easy Clinic (Doing Business As)

Practice location

43875 Washington St
Suite #c
Palm Desert, CA 92211-8249

Phone 951-539-8984

Mailing address

1611 Crenshaw Blvd
Suite 224
Torrance, CA 90501-3123

Phone 310-539-5722

Authorized official

Martha N Mozia
Ceo
31053955722

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