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WHITEHEAD FAMILY WELLNESS CLINIC
NPI 1053179911
Nurse Practitioner - Primary Care in Los Angeles, CA

Active since March 06, 2024
12813 AVALON BLVD, LOS ANGELES, CA 90061(310) 819-8310(310) 819-8178 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Whitehead Family Wellness Clinic NPPES

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

WHITEHEAD FAMILY WELLNESS CLINIC (NPI 1053179911) is a healthcare organization registered as a primary care in Los Angeles, California and active in the NPI registry since March 2024. The organization lists Aurelia Whitehead, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1053179911
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameWHITEHEAD FAMILY WELLNESS CLINIC
Location Address12813 AVALON BLVDLos Angeles, CA 90061-2731
Mailing Address12813 Avalon BlvdLos Angeles, CA 90061-2731 · (310) 819-8310 · Fax (310) 819-8178
Phone(310) 819-8310
Fax(310) 819-8178
Organization SubpartNo
Authorized OfficialAurelia WhiteheadChief Executive Officer · (323) 200-6418
Enumeration DateMarch 6, 2024
NPPES CertifiedMarch 6, 2024
✔ NPI 1053179911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
12813 AVALON BLVD, Los Angeles, CA 90061
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Whitehead Family Wellness Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Whitehead Family Wellness Clinic, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Dion Whitehead, NP
Nurse Practitioner
NPI 1790303964
7456 WESTCLIFF WAY
Eastvale, CA 92880
(951) 202-7483
✔ PECOS41 mi
Aurelia Whitehead, NP
Nurse Practitioner
NPI 1558988295
15486 DAYBREAK LN
Fontana, CA 92337
(562) 544-7618
✔ PECOS✔ Accepts Medicare47 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Whitehead Family Wellness Clinic's NPI number?

The NPI number for Whitehead Family Wellness Clinic is 1053179911. It was assigned to this organization in the NPPES registry on March 6, 2024.

Where is Whitehead Family Wellness Clinic located?

Whitehead Family Wellness Clinic is located at 12813 Avalon Blvd, Los Angeles, CA 90061. The listed phone number is (310) 819-8310.

What is Whitehead Family Wellness Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Whitehead Family Wellness Clinic enrolled in Medicare?

Yes. Whitehead Family Wellness Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Whitehead Family Wellness Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Whitehead Family Wellness Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Whitehead Family Wellness Clinic was last updated on March 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.