# BLEUX ONYX HEALTH & WELLNESS A PROFESSIONAL NURSING CORPORATION

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

## Provider details

- **NPI number:** 1366374282
- **Authorized official:** TANISHA RENEE RAGLAND PMHNP-BC, DNP (PRESIDENT & CEO)
- **Authorized official phone:** (585) 721-5686

## Contact information

- **Practice address:** 2830 S KERCKHOFF AVE, SAN PEDRO, CA 90731-6626
- **Practice address phone:** (949) 436-5536
- **Mailing address:** 2830 S KERCKHOFF AVE, SAN PEDRO, CA 90731-6626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/03/2026
- **Last updated:** 06/03/2026