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Organization
MINDFUL MOON WELLNESS, LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CORPORATION
Active
Organization
MINDFUL MOON WELLNESS, LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIQUE RENATE VARGAS (CEO/DIRECTOR)
(909) 545-5368
Entity
Organization
Contact information
Practice address
637 MULVIHILL AVENUE, REDLANDS, CA 92374-2435
(909) 545-5368
Mailing address
8605 SANTA MONICA BLVD, PMB 240649, WEST HOLLYWOOD, CA 90069-4109
(909) 545-5368
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/24/2026
Last updated
07/24/2026
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