# WELLNESS INTEGRATIVE, PLC

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

## Provider details

- **NPI number:** 1619330388
- **Authorized official:** JENNIVYR DERAKHSHAN (OWNER)
- **Authorized official phone:** (928) 318-6910

## Contact information

- **Practice address:** 1207 W 16TH ST STE B, YUMA, AZ 85364-4597
- **Practice address phone:** (928) 318-6310
- **Practice address fax:** (928) 328-1056
- **Mailing address:** 1207 W 16TH ST STE B, YUMA, AZ 85364-4597
- **Mailing address phone:** (928) 318-6310
- **Mailing address fax:** (928) 328-1056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/31/2016
- **Last updated:** 04/15/2020