Organization
SACRED PATH INDIGENOUS WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE JOHNSON PH.D. (CEO)
(626) 290-1505
Entity
Organization
Contact information
Practice address
2232 KINGSBRIDGE CT, SAN DIMAS, CA 91773-3757
(626) 290-1505
Mailing address
2232 KINGSBRIDGE CT, SAN DIMAS, CA 91773-3757
(626) 290-1505
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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