Whitehead Family Wellness Clinic

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

WHITEHEAD FAMILY WELLNESS CLINIC

Practice address

12813 Avalon Blvd
Los Angeles, CA 90061-2731

Phone

(310) 819-8310

Fax

(310) 819-8178

NPI assigned

Mar 6, 2024

Last updated

Mar 6, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aurelia Whitehead, FNPNPI 1558988295

Title

Chief Executive Officer

Phone

(323) 200-6418

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aurelia Whitehead, NP

  • Family Nurse Practitioner
  • Fontana, CA
  • NPI 1558988295
  Medicare reassignment Authorized official
• Dion Whitehead, NP

  • Family Nurse Practitioner
  • Eastvale, CA
  • NPI 1790303964
  Medicare reassignment NPD
• Michael K. Wensley, M.D.

  • Specialist
  • West Hollywood, CA
  • NPI 1841336740
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1053179911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12813 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612731",
            "telephone_number": "310-819-8310",
            "fax_number": "310-819-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12813 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612731",
            "telephone_number": "310-819-8310",
            "fax_number": "310-819-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEHEAD FAMILY WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "AURELIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-200-6418",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tommie Lee White, PH.D.
• Valerie Celeste White, MSW
• Whitecap Network
• Michael Marshall Whited
• Chloe Whiteford, MA, OT
• Olivia Rose Whitehead
• Quanesha Whitehead
• Gregory David Whitehill, MD
• Rachel Hope Whitehill, DDS
• Dailey Whitehouse, ASW

• Primary Care Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.