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General NPI Number Information
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NPI Number | 1215666847
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC NURSING CONSULTANT PC
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 619-914-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 530-768-2211
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | MRS. LASHAUNDA RENEE JETHRO
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Credential | DNP
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Telephone | 618-789-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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