Organization
ULTIMATE WELLNESS PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA GALLIVAN PHD (PRESIDENT/CEO)
(424) 289-0299
Entity
Organization
Contact information
Practice address
10940 WILSHIRE BLVD STE 1600, LOS ANGELES, CA 90024-3910
(424) 289-0299
Mailing address
10940 WILSHIRE BLVD STE 1600, LOS ANGELES, CA 90024-3910
(424) 289-0299
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/07/2025
Last updated
07/26/2025
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