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General NPI Number Information
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NPI Number | 1700643111
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Entity Type | Organization
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Legal Business Name | HOMECOMING PSYCHIATRY INC
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1000 S COAST DR APT F206
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City | COSTA MESA
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State | CA
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Zip | 92626-7740
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Country | US
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Telephone | 714-386-9766
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Fax |
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Provider Business Mailing Address
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Address Line | 301 BAYVIEW CIR STE 104
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2948
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Country | US
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Telephone | 714-386-9766
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANAM GULRAIZ
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Credential | PMHNP-BC
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Telephone | 714-386-9766
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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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