Fountain of Life Centre

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

193200000X Issued in CA

Legal business name

FOUNTAIN OF LIFE CENTRE

Practice address

350 W 5TH Street
Suite 105 1/2
San Pedro, CA 90731-2751

Phone

(310) 940-1259

Fax

(424) 477-5398

NPI assigned

Sep 13, 2016

Organization subpart

No

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

Authorized official

Name

Linda S Tweten, PAR,CCS PATIENT ACCO

Title

General Manager

Phone

(310) 940-1259

Specialties & licenses 1

Addresses

Other names 1

• North End Spinal Treatment Other name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Baptist Conca, D.C.

  • Chiropractor
  • Redondo Beach, CA
  • NPI 1427394014
  NPD (past)
• Jeffrey S. Millan, D.C.

  • Chiropractor
  • San Pedro, CA
  • NPI 1568757037
  NPD (past)
• Kathi Wolfrum, D.C.

  • Chiropractor
  • San Pedro, CA
  • NPI 1659402261
  NPD (past)

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1083162630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 TORRANCE BLVD",
            "address_2": "PMB #464",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034100",
            "telephone_number": "310-940-1259",
            "fax_number": "424-477-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 5TH STREET",
            "address_2": "SUITE 105 1/2",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312751",
            "telephone_number": "310-940-1259",
            "fax_number": "424-477-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN OF LIFE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "TWETEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "310-940-1259",
        "authorized_official_credential": "PAR,CCS PATIENT ACCO"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "193200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North End Spinal Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brian D. Fong, M.D.
• Kristi Fonseca
• Erin Fontenot
• Mary Anne Forrester
• Curtis Alan Foster
• Francisco J. Correa, M.D., Inc
• Kristian Franco, IDHS
• Lauren Marie Frank
• Fratt Dental Corporation (San Pedro Dental)
• Steven Frausto, LCSW

• Case Manager/Care Coordinator in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.