Provider Demographics
NPI:1073328316
Name:WELLNESS BRIDGE NURSING CORPORATION
Entity type:Organization
Organization Name:WELLNESS BRIDGE NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BETZY
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOKI-MWANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-633-7302
Mailing Address - Street 1:27816 WHITTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7890
Mailing Address - Country:US
Mailing Address - Phone:909-633-7302
Mailing Address - Fax:
Practice Address - Street 1:43537 RIDGE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3613
Practice Address - Country:US
Practice Address - Phone:951-595-7391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235649757Medicaid