| Wellness Equity Alliance | |
|
3002 Whittier Blvd Los Angeles CA 90023-1637 | |
| (408) 341-9606 | |
| Not Available |
| Full Name | Wellness Equity Alliance |
|---|---|
| Speciality | Clinic/Center |
| Location | 3002 Whittier Blvd, Los Angeles, California |
| Authorized Official Name and Position | Tyler Blair Evans (CEO) |
| Authorized Official Contact | 9176481068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Equity Alliance 250 Quail Ridge Rd Scotts Valley CA 95066-4821 Ph: (408) 341-6906 | Wellness Equity Alliance 3002 Whittier Blvd Los Angeles CA 90023-1637 Ph: (408) 341-9606 |
| NPI Number | 1699471482 |
|---|---|
| Provider Enumeration Date | 02/02/2023 |
| Last Update Date | 09/01/2026 |
| Certification Date | 09/01/2026 |
| Medicare PECOS PAC ID | 8527433085 |
|---|---|
| Medicare Enrollment ID | O20230414000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699471482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Wendy Bernstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629120845 PECOS PAC ID: 5799965497 Enrollment ID: I20110214000187 |
| Provider Name | Lyle C Cook |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316237498 PECOS PAC ID: 1456529619 Enrollment ID: I20110714000604 |
| Provider Name | Tyler Evans |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912227125 PECOS PAC ID: 9335311059 Enrollment ID: I20170523002901 |
| Provider Name | Daniel Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063805893 PECOS PAC ID: 7214288869 Enrollment ID: I20251007003037 |
| Provider Name | Woodrow Augustus Myers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407910284 PECOS PAC ID: 5395835052 Enrollment ID: I20260205001948 |
| Provider Name | Lucy E Marrero |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154688570 PECOS PAC ID: 1153890983 Enrollment ID: I20260520004325 |
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