| Aetheria Aesthetics & Wellness, Inc. | |
|
901 N Heritage Dr Ste 103 Ridgecrest CA 93555-5541 | |
| (760) 282-4931 | |
| (760) 282-4931 |
| Full Name | Aetheria Aesthetics & Wellness, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 901 N Heritage Dr Ste 103, Ridgecrest, California |
| Authorized Official Name and Position | Jonathan Gary Hodor (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7602824931 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aetheria Aesthetics & Wellness, Inc. 901 N Heritage Dr Ste 103 Ridgecrest CA 93555-5541 Ph: (760) 282-4931 | Aetheria Aesthetics & Wellness, Inc. 901 N Heritage Dr Ste 103 Ridgecrest CA 93555-5541 Ph: (760) 282-4931 |
| NPI Number | 1700750197 |
|---|---|
| Provider Enumeration Date | 09/30/2025 |
| Last Update Date | 01/13/2026 |
| Certification Date | 01/13/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700750197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 202D00000X | Integrative Medicine | (NU) | Secondary |
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