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General NPI Number Information
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NPI Number | 1366388092
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Entity Type | Organization
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Legal Business Name | PSYCHE INTEGRATIVE WELLNESS, A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 517 S IVY AVE
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City | MONROVIA
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State | CA
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Zip | 91016-2827
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Country | US
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Telephone | 760-491-3146
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Fax |
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Provider Business Mailing Address
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Address Line | 517 S IVY AVE
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City | MONROVIA
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State | CA
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Zip | 91016-2827
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Country | US
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Telephone | 760-491-3146
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Fax |
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Authorized Official
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Title or Position | OWNER/NP
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Name | JACLYN HILL
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Credential | PMHNP
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Telephone | 760-491-3146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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