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General NPI Number Information
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NPI Number | 1073053732
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Entity Type | Organization
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Legal Business Name | KEYNAN HOBBS NURSING, INC.
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 8900 GROSSMONT BLVD # 4-3
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City | LA MESA
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State | CA
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Zip | 91941-4047
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Country | US
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Telephone | 858-380-7691
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 GROSSMONT BLVD # 4-3
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City | LA MESA
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State | CA
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Zip | 91941-4047
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Country | US
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Telephone | 858-380-7691
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEYNAN HOBBS
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Credential | MSN, RN, PMHCNS-BC
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Telephone | 858-380-7691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | C3975090
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License Number State | CA
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