Organization
PRIMERA WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI BENNETT (ADMINISTRATOR)
(951) 423-2202
Entity
Organization
Contact information
Practice address
1603 BABCOCK RD STE 238-2, SAN ANTONIO, TX 78229-4708
(210) 563-3779
(951) 462-1161
Mailing address
6956 INDIANA AVE STE 5, RIVERSIDE, CA 92506-4109
(951) 423-2202
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
06/07/2020
Last updated
06/07/2020
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