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General NPI Number Information
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NPI Number | 1043962079
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Entity Type | Organization
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Legal Business Name | MINDFUL NATURE PRACTICE: A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 147 ROSS ST APT 1
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City | SAN RAFAEL
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State | CA
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Zip | 94901-4958
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Country | US
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Telephone | 415-578-0343
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Fax |
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Provider Business Mailing Address
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Address Line | 147 ROSS ST APT 1
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City | SAN RAFAEL
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State | CA
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Zip | 94901-4958
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Country | US
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Telephone | 415-578-0343
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENISE MICHELLE BELANGER
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Credential | PHD, PMHNP, CMT-P
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Telephone | 415-578-0343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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