Healthcare Provider Details

I. General information

NPI: 1851237085
Provider Name (Legal Business Name): NEW LEAF INTEGRATIVE MENTAL HEALTH NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 HIGHLAND POINTE DR STE 250
ROSEVILLE CA
95678-5421
US

IV. Provider business mailing address

915 HIGHLAND POINTE DR STE 250
ROSEVILLE CA
95678-5421
US

V. Phone/Fax

Practice location:
  • Phone: 916-866-8249
  • Fax: 916-251-0465
Mailing address:
  • Phone: 916-866-8249
  • Fax: 916-251-0465

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: PERIS RODRIGUEZ
Title or Position: ADMIN
Credential: NP
Phone: 650-695-3354