NPIMap

Organization Active NPI

Healed Women Heal, Inc.

  • Prevention Professional
  • Pomona, CA
National Provider Identifier
1366282188
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
Legal business name
HEALED WOMEN HEAL, INC.
Practice address
436 W 4TH St # 225
Pomona, CA 91766-1622
Phone
(909) 815-7815
NPI assigned
May 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Mrs. Tracy Evanson, MSNPI 1275076010
Title
Executive Director
Phone
(909) 815-7815

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Prevention ProfessionalGroup: 193200000X MULTI-SPECIALTY GROUP 405300000X Primary

Addresses

Primary practice location

436 W 4TH St # 225
Pomona, CA 91766-1622

Mailing address

436 W 4TH St # 225
Pomona, CA 91766-1622
Phone (909) 815-7815

Other names 1

  • Healed Women Heal Doing business as

National Provider Directory

National Provider Directory

Locations

436 W 4th St
#225
Pomona, CA 91766
Phone (909) 815-7815

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1366282188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 W 4TH ST # 225",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661622",
            "telephone_number": "909-815-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 W 4TH ST # 225",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661622",
            "telephone_number": "909-815-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALED WOMEN HEAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "EVANSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-815-7815",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healed Women Heal",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healed Women Heal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.