Healthcare Provider Details

I. General information

NPI: 1538044565
Provider Name (Legal Business Name): PSYCHIATRY AND MENTAL HEALTH, A PHYSICIAN ASSISTANT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17074 DEVONSHIRE ST
NORTHRIDGE CA
91325-1617
US

IV. Provider business mailing address

17074 DEVONSHIRE ST
NORTHRIDGE CA
91325-1617
US

V. Phone/Fax

Practice location:
  • Phone: 818-804-8227
  • Fax: 888-801-0607
Mailing address:
  • Phone: 818-804-8227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ERWIN HERNANDEZ
Title or Position: VICE PRESIDENT
Credential:
Phone: 818-804-8227