Healthcare Provider Details

I. General information

NPI: 1710835988
Provider Name (Legal Business Name): SERAPHIC WELLNESS CENTER, INCORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 TRUXEL RD STE 170
SACRAMENTO CA
95834-3795
US

IV. Provider business mailing address

5006 BRIMLEY WAY
SACRAMENTO CA
95835-1616
US

V. Phone/Fax

Practice location:
  • Phone: 916-272-9195
  • Fax:
Mailing address:
  • Phone: 916-272-9195
  • Fax: 916-251-0412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TINUKE SHADE OLALERE
Title or Position: NURSE PRACTITIONER
Credential: PMHNP-BC
Phone: 916-272-9195