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General NPI Number Information
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NPI Number | 1568011880
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Entity Type | Organization
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Legal Business Name | ADVANCED ACTION MENTAL HEALTH NP, A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 12340 SEAL BEACH BLVD STE B187
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City | SEAL BEACH
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State | CA
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Zip | 90740-2792
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Country | US
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Telephone | 504-814-0084
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Fax | 310-300-1814
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Provider Business Mailing Address
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Address Line | 12340 SEAL BEACH BLVD STE B187
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City | SEAL BEACH
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State | CA
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Zip | 90740-2792
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Country | US
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Telephone | 504-814-0084
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Fax | 310-300-1814
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. KESHA SAUCIER
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Credential | NP
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Telephone | 504-814-0084
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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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