Healthcare Provider Details

I. General information

NPI: 1679414650
Provider Name (Legal Business Name): MIND CENTER PSYCHIATRY ADVANCED NURSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 ROSECRANS AVE
EL SEGUNDO CA
90245-4903
US

IV. Provider business mailing address

710 N EUCLID ST STE 208
ANAHEIM CA
92801-4132
US

V. Phone/Fax

Practice location:
  • Phone: 909-702-5650
  • Fax: 888-851-3613
Mailing address:
  • Phone: 909-702-5650
  • Fax: 888-851-3613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MUMBI NGUNJIRI KAIRU
Title or Position: DIRECTOR
Credential: PMHNP
Phone: 909-702-5650