MEDICARE: MONTEREY BAY PSYCHIATRY, ADVANCED PRACTICE NURSING INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1649116096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEREY BAY PSYCHIATRY, ADVANCED PRACTICE NURSING INC.

Provider Business Mailing Address
First Line	:	126 CLOCK TOWER PL STE 104C
Second Line	:
City	:	CARMEL
State	:	CA
Zip	:	93923-8791
Country	:	US
Telephone Number	:	831-200-3758
Fax Number	:	831-480-1840

Provider Business Practice Location Address
First Line	:	126 CLOCK TOWER PLACE
Second Line	:	SUITE 104C
City	:	CARMEL VALLEY
State	:	CA
Zip	:	93924-9567
Country	:	US
Telephone Number	:	831-200-3758
Fax Number	:	831-480-1840

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HALLEH ENTEKHABI
Credential	:	DNP, PNP, PMHNP
Telephone Number	:	831-200-3758

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	06/02/2026

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