Healthcare Provider Details

I. General information

NPI: 1881339513
Provider Name (Legal Business Name): NU LEAF MENTAL HEALTH GROUP PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 BUSINESS CENTER DR STE 101
IRVINE CA
92612-1001
US

IV. Provider business mailing address

2102 BUSINESS CENTER DR STE 101
IRVINE CA
92612-1001
US

V. Phone/Fax

Practice location:
  • Phone: 661-627-8209
  • Fax:
Mailing address:
  • Phone: 661-627-8209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER ANTHONY SANCHEZ
Title or Position: OWNER
Credential: MSN, RN, PMHNP-BC
Phone: 562-541-8950