Provider Demographics
NPI:1538931993
Name:NEUROMATTERS AND WELLNESS
Entity type:Organization
Organization Name:NEUROMATTERS AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDEE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SAN MATEO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:616-306-3920
Mailing Address - Street 1:894 CAMINO CANTERA
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-3332
Mailing Address - Country:US
Mailing Address - Phone:619-306-3920
Mailing Address - Fax:
Practice Address - Street 1:333 H ST STE 5000
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5561
Practice Address - Country:US
Practice Address - Phone:619-306-3920
Practice Address - Fax:619-500-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty