Pediatric Health and Wellness

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

G66133 Issued in CA

Legal business name

PEDIATRIC HEALTH AND WELLNESS

Doing business as

Proyouth

Practice address

6815 Five Star Blvd Ste 100
Rocklin, CA 95677

Phone

(916) 626-3060

Fax

(916) 626-3063

NPI assigned

Dec 16, 2014

Organization subpart

No

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

Authorized official

Name

Sunnie L Skiles, MD

Title

MD

Phone

(916) 626-3060

Specialties & licenses 1

Addresses

Other names 1

• Proyouth Doing business as

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535500800000",
    "number": "1124426580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 FIVE STAR BLVD STE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772691",
            "telephone_number": "916-626-3060",
            "fax_number": "916-626-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 FIVE STAR BLVD STE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "95677",
            "telephone_number": "916-626-3060",
            "fax_number": "916-626-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-16",
        "last_updated": "2018-08-29",
        "status": "A",
        "authorized_official_last_name": "SKILES",
        "authorized_official_first_name": "SUNNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "916-626-3060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G66133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proyouth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proyouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlin Jean Payne
• Melissa Pazos
• Christopher David Pearson
• Teresa Dawn Pearson
• Joshua Pechal, NONE
• Kiana Penaska-Flores
• Juliana Nicole Pendergrass
• Sheila M Peoples
• Sarina Pera
• Aaron Pereira

• Primary Care Clinic/Center in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.