| Restorative Health & Wellness Inc | |
|
1233 W Shaw Ave Ste 103 Fresno CA 93711-3718 | |
| (559) 206-7680 | |
| (559) 892-4550 |
| Full Name | Restorative Health & Wellness Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1233 W Shaw Ave Ste 103, Fresno, California |
| Authorized Official Name and Position | Devon Casida (RNP/OWNER) |
| Authorized Official Contact | 5592944794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restorative Health & Wellness Inc Po Box 25042 Fresno CA 93729-5042 Ph: (559) 892-4500 | Restorative Health & Wellness Inc 1233 W Shaw Ave Ste 103 Fresno CA 93711-3718 Ph: (559) 206-7680 |
| NPI Number | 1124717798 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/01/2023 |
| Medicare PECOS PAC ID | 7719323534 |
|---|---|
| Medicare Enrollment ID | O20240314001721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124717798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Devon Lagrace Casida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922586643 PECOS PAC ID: 5092067983 Enrollment ID: I20181003002288 |
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