Healthcare Provider Details

I. General information

NPI: 1710717988
Provider Name (Legal Business Name): DESERT ORCHID HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 08/03/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 GREEN VISTA DR STE 106
SPARKS NV
89431-8515
US

IV. Provider business mailing address

401 RYLAND ST STE 200A
RENO NV
89502-1643
US

V. Phone/Fax

Practice location:
  • Phone: 775-622-8890
  • Fax: 775-622-8920
Mailing address:
  • Phone: 650-576-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE S WADE
Title or Position: MANAGING MEMBER/APRN-CNP, PMHNP-BC
Credential: APRN-CNP, PMHNP-BC
Phone: 650-576-7300