Pacific Heartwood Wellness PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PACIFIC HEARTWOOD WELLNESS PC

Practice address

1451 River Park Dr Ste 100
Sacramento, CA 95815-4518

Phone

(916) 292-9700

NPI assigned

Jul 5, 2023

Last updated

Jul 11, 2023By 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

Lauren Gordon

Title

Clinic Manager

Phone

(916) 799-6259

Specialties & licenses 1

Addresses

Other names 1

• Pacific Heartwood Wellness Other name

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.

• Sandy Ngo Moubarek, MD

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1033746722
  NPD (past)
• Nichakarn Yordduangjun, MD

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1376127738
  NPD (past)
• Leonard Marinis, MD

  • Psychiatry Physician
  • Rocky River, OH
  • NPI 1134624141
  NPD (past)

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1639856206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 RIVER PARK DR STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154518",
            "telephone_number": "916-292-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 RIVER PARK DR STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154518",
            "telephone_number": "916-292-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEARTWOOD WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "916-799-6259"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Heartwood Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pacific MD Housecalls
• Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)
• Pacific Medical, Inc.
• Pacific Sacramento Surgery Center, LLC
• Pacific Skin Institute

• Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.