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General NPI Number Information
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NPI Number | 1669324521
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Entity Type | Organization
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Legal Business Name | RAVEN'S EYE MENTAL WELLNESS AND NURSING SERVICES, INC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 333 H ST. STE 5000
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City | CHULA VISTA
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State | CA
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Zip | 91910
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Country | US
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Telephone | 415-649-5338
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Fax | 833-222-8128
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Provider Business Mailing Address
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Address Line | 727 BROADWAY ST # 1057
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City | VALLEJO
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State | CA
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Zip | 94590-3305
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Country | US
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Telephone | 415-649-5338
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Fax | 833-222-8128
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELIZABETH ANNA BLOCK
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Credential | PHMNP-BC
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Telephone | 415-649-5338
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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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