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General NPI Number Information
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NPI Number | 1730919929
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Entity Type | Organization
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Legal Business Name | SERENE MYND PSYCHIATRIC NURSING SERVICES INC
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Dates
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Enumeration Date | 08/03/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 401 VERNON ST STE B
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City | ROSEVILLE
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State | CA
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Zip | 95678-2600
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Country | US
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Telephone | 916-449-0475
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Fax | 916-848-6949
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Provider Business Mailing Address
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Address Line | 401 VERNON ST STE B
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City | ROSEVILLE
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State | CA
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Zip | 95678-2600
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Country | US
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Telephone | 916-449-0475
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER EVANS
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Credential | ARNP
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Telephone | 916-449-0475
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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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