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General NPI Number Information
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NPI Number | 1174456883
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Entity Type | Organization
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Legal Business Name | MACMASTER PSYCHIATRIC SERVICES A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 1510 S BARKER ST
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City | MOUNTAIN HOUSE
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State | CA
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Zip | 95391-1473
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Country | US
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Telephone | 559-776-8864
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Fax |
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Provider Business Mailing Address
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Address Line | 1510 S BARKER ST
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City | MOUNTAIN HOUSE
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State | CA
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Zip | 95391-1473
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Country | US
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Telephone | 559-776-8864
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACOB MARTIN MACMASTER
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Credential | PMHNP
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Telephone | 559-776-8864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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