Healthcare Provider Details

I. General information

NPI: 1053246934
Provider Name (Legal Business Name): RIVER AND SEA PSYCHIATRIC AND MENTAL HEALTH SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E CARTER ST
BOISE ID
83706-5274
US

IV. Provider business mailing address

315 E CARTER ST
BOISE ID
83706-5274
US

V. Phone/Fax

Practice location:
  • Phone: 858-769-9664
  • Fax:
Mailing address:
  • Phone: 858-769-9664
  • Fax:

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: LAUREN REED
Title or Position: OWNER
Credential:
Phone: 858-769-9664