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OBSIDIAN BLACKWOLF
NPI 1043010069
Rehabilitation Practitioner in Huntington Park, CA

Active since March 18, 2025
2677 ZOE AVE STE 304, HUNTINGTON PARK, CA 90255(323) 346-0960 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 13, 2025, Mar 18, 2025 (2 updates tracked since 2025).

About Obsidian Blackwolf NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OBSIDIAN BLACKWOLF (NPI 1043010069) is an individual rehabilitation practitioner in Huntington Park, California and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1043010069
Entity TypeIndividualMale
Primary Taxonomy225400000X
Provider Legal NameOBSIDIAN BLACKWOLF
Location Address2677 ZOE AVE STE 304Huntington Park, CA 90255-3699
Mailing Address2677 Zoe Ave Ste 304Huntington Park, CA 90255-3699
Phone(323) 346-0960
Sole ProprietorYes
Enumeration DateMarch 18, 2025
Last NPPES UpdateAugust 13, 20252 updates tracked since enumeration
NPPES CertifiedAugust 13, 2025
✔ NPI 1043010069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225400000X
Definition

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

2677 ZOE AVE STE 304, Huntington Park, CA 90255
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TINA SANDOVAL
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
CHRISTINE BAIK
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
ANDREA ARZAGA
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
JOSE LUIS ANDRADE
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
SHEAKIMA MOORE
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
FALLON PORTER SIEGLER
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
SOPHIA GILLEN
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960
STACY MOODY
Rehabilitation Practitioner
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255
Los Angeles County (323) 346-0960

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Obsidian Blackwolf's NPI number?

The NPI number for Obsidian Blackwolf is 1043010069. It was assigned to this individual provider in the NPPES registry on March 18, 2025.

Where is Obsidian Blackwolf located?

Obsidian Blackwolf practices at 2677 Zoe Ave Ste 304, Huntington Park, CA 90255. The listed phone number is (323) 346-0960.

What is Obsidian Blackwolf's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

When was this NPI record last updated?

The NPPES record for Obsidian Blackwolf was last updated on August 13, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.