Healthcare Provider Details

I. General information

NPI: 1225953755
Provider Name (Legal Business Name): NEW CHAPTER MENTAL HEALTH NURSING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6386 ALVARADO CT STE 201-01
SAN DIEGO CA
92120-4905
US

IV. Provider business mailing address

4612 REVILLO WAY
SAN DIEGO CA
92115-4144
US

V. Phone/Fax

Practice location:
  • Phone: 760-985-7397
  • Fax:
Mailing address:
  • Phone: 760-985-7397
  • Fax:

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: KYLE MARTIN GAMBILL
Title or Position: PRESIDENT
Credential: RN/PMHNP
Phone: 760-985-7397