Aetheria Aesthetics & Wellness, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AETHERIA AESTHETICS & WELLNESS, INC.

Practice address

901 N Heritage Dr Ste 103
Ridgecrest, CA 93555-5541

Phone

(760) 282-4931

Fax

(760) 282-4931

NPI assigned

Sep 30, 2025

Last updated

Jan 13, 2026By 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

Jonathan Gary Hodor, DO

Title

Medical Director

Phone

(760) 282-4931

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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.

• Ma Jinky Hechanova Mallory, RN

  • Registered Nurse
  • Ridgecrest, CA
  • NPI 1659100675
  NPD

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

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1700750197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N HERITAGE DR STE 103",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555541",
            "telephone_number": "760-282-4931",
            "fax_number": "760-282-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N HERITAGE DR STE 103",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555541",
            "telephone_number": "760-282-4931",
            "fax_number": "760-282-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AETHERIA AESTHETICS & WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-30",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "HODOR",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "760-282-4931",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Albertsons LLC (Savon Pharmacy #0331)

• Family Medicine Physician in Ridgecrest, CA
• Providers in Ridgecrest, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.