| Premier Wellness Professional Nursing Corporation | |
|
2648 International Blvd Ste 115 Pmb 1120 Oakland CA 94601-1569 | |
| (510) 761-7274 | |
| (972) 845-8004 |
| Full Name | Premier Wellness Professional Nursing Corporation |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2648 International Blvd Ste 115, Oakland, California |
| Authorized Official Name and Position | Joan Nichole Taylor (OWNER) |
| Authorized Official Contact | 5107952434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Wellness Professional Nursing Corporation 2648 International Blvd Ste 301 Oakland CA 94601-1580 Ph: (510) 761-7274 | Premier Wellness Professional Nursing Corporation 2648 International Blvd Ste 115 Pmb 1120 Oakland CA 94601-1569 Ph: (510) 761-7274 |
| NPI Number | 1366322265 |
|---|---|
| Provider Enumeration Date | 09/03/2025 |
| Last Update Date | 05/22/2026 |
| Certification Date | 05/22/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366322265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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