Healthcare Provider Details
I. General information
NPI: 1891641320
Provider Name (Legal Business Name): MCENTEE NURSING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
253 10TH AVE UNIT 422
SAN DIEGO CA
92101-7456
US
IV. Provider business mailing address
253 10TH AVE UNIT 422
SAN DIEGO CA
92101-7456
US
V. Phone/Fax
- Phone: 510-329-0998
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAWRENCE
BRADLEY
MCENTEE
Title or Position: PRESIDENT
Credential: PMHNP
Phone: 510-329-0998