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NPI 1043114648

NPI 1043114648 : QUIET MIND PSYCHIATRY : SANTA ROSA, CA

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General NPI Number Information
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    NPI Number           |    1043114648
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    Entity Type          |    Organization 
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    Legal Business Name  |    QUIET MIND PSYCHIATRY 
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Dates
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    Enumeration Date     |    10/06/2026
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    Last Update Date     |    10/06/2026
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Provider Practice Location Address
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    Address Line         |    100 FOLEY ST 
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    City                 |    SANTA ROSA
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    State                |    CA
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    Zip                  |    95401-4209
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    Country              |    US
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    Telephone            |    916-234-3301
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 19231 
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95819-0231
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    Country              |    US
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    Telephone            |    916-234-3301
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     RYAN  COURDY 
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    Credential           |    MD
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    Telephone            |    916-234-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    
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    License Number State |    NULL
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