# WAVE LIFE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093594202
- **Authorized official:** MRS. MARGARET ANNE MELTON (CHIEF EXECUTIVE ASSISTANT)
- **Authorized official phone:** (580) 291-6961

## Contact information

- **Practice address:** 158 GOYA RD, PORTOLA VALLEY, CA 94028-7307
- **Practice address phone:** (917) 601-6840
- **Mailing address:** 700 EL CAMINO REAL STE 120, MENLO PARK, CA 94025-4884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2023
- **Last updated:** 09/26/2023