NPIMap

Organization Active NPI

Live Well Naturopathic Clinic, a Professional Corporation

  • Naturopath
  • La Quinta, CA
National Provider Identifier
1861639700
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
331 Issued in CA
Legal business name
LIVE WELL NATUROPATHIC CLINIC, A PROFESSIONAL CORPORATION
Practice address
78900 Avenue 47 Ste 102
La Quinta, CA 92253-2070
Phone
(760) 771-5970
Fax
(760) 771-5982
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Sonja N Fung, NDNPI 1326285800
Title
Medical Director
Phone
(213) 268-8884

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193400000X SINGLE SPECIALTY GROUP 175F00000X 331 CA Primary

Addresses

Primary practice location

78900 Avenue 47 Ste 102
La Quinta, CA 92253-2070

Mailing address

78900 Avenue 47
Suite 102
La Quinta, CA 92253-7168
Phone (760) 771-5970

Other names 1

  • Live Well Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2036429Live Well Clinic78900 Avenue 47 Ste 102, La Quinta, CA 92253Certificate of waiverFeb 6, 2028

National Provider Directory

National Provider Directory

Locations

78900 Avenue 47
Ste 102
La Quinta, CA 92253
Phone (760) 600-5325

Practitioners & affiliated clinicians

Practitioners 9

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": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861639700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78900 AVENUE 47",
            "address_2": "SUITE 102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537168",
            "telephone_number": "760-771-5970",
            "fax_number": "760-771-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78900 AVENUE 47 STE 102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532070",
            "telephone_number": "760-771-5970",
            "fax_number": "760-771-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL NATUROPATHIC CLINIC, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FUNG",
        "authorized_official_first_name": "SONJA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "213-268-8884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": "CA",
            "license": "331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Well Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.