Vitaboost Wellness

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

VITABOOST WELLNESS

Practice address

20955 Devonshire St
Chatsworth, CA 91311-2313

Phone

(310) 877-8067

Fax

(818) 280-3874

NPI assigned

Nov 1, 2021

Last updated

Nov 1, 2021By 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

Dr. Audra Elaine Ford, MD

Title

Medical Director

Phone

(310) 877-8067

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1891450250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20955 DEVONSHIRE ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112313",
            "telephone_number": "310-877-8067",
            "fax_number": "818-280-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20955 DEVONSHIRE ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112313",
            "telephone_number": "310-877-8067",
            "fax_number": "818-280-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITABOOST WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-877-8067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allan Villarasa, LVN
• Laura Janeth Villarreal, FNP
• Orlando Miguel Villazevallos
• Yessica Vivian Villegas Temblador
• Violet Home Health Care
• Vitaboost Wellness Center (Vitality Boost Wellness)
• Ivan Vivanco
• Vmed Express Inc.
• Walgreen Co (Walgreens #07015)
• Jesse Wallace

• Infusion Therapy Clinic/Center in Chatsworth, CA
• Providers in Chatsworth, CA by specialty
• Infusion Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.