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Organization
COMMUNITY WELL CALIFORNIA
Active
Organization
COMMUNITY WELL CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER R PORTER (EXECUTIVE DIRECTOR)
(909) 419-9278
Entity
Organization
Contact information
Practice address
626 W LANCASTER BLVD # 61, LANCASTER, CA 93534-3108
(909) 990-1155
(424) 361-7766
Mailing address
626 W LANCASTER BLVD # 61, LANCASTER, CA 93534-3108
(909) 419-9278
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114749306
—
CA
05
—
1700657038
—
CA
Enumeration date
02/19/2024
Last updated
10/29/2025
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