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General NPI Number Information
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NPI Number | 1568323418
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Entity Type | Organization
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Legal Business Name | SYNERGY BEHAVIORAL MENTAL HEALTH AND WELLNESS CARE
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 2108 N ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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Country | US
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Telephone | 209-215-5124
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Fax |
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Provider Business Mailing Address
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Address Line | 2344 ST PAULS WAY
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City | MODESTO
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State | CA
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Zip | 95355-3390
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Country | US
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Telephone | 832-904-2349
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | DAVIDSON ETOAMAIHE
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Credential | NP
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Telephone | 832-904-2349
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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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