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General NPI Number Information
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NPI Number | 1598569436
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Entity Type | Individual
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Provider Name | BLANCA ESTELA SIERRA PINEDA PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 3100 PORTER CREEK RD
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City | SANTA ROSA
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State | CA
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Zip | 95404-8447
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Country | US
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Telephone | 707-694-3104
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 PORTER CREEK RD
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City | SANTA ROSA
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State | CA
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Zip | 95404-8447
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2025008241
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License Number State | CA
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